三种方法治疗胫骨干骨折的比较

Comparison of Three Methods Treating Tibial Shaft Fractures

目的 探讨胫骨干骨折的合理固定方法。方法 1 1 0名从 1 996年 1月～ 2 0 0 3年 1 0月在本院收治的胫骨骨折患者共 1 1 2个肢体 ,采用三种固定方法治疗 :AO钢板 4 6例 ,单臂外固定架 2 9例 ,带锁髓内钉37例。所有患者均进行随访并观察术后的平均愈合时间、感染率、骨不连率和并发症。结果 平均愈合时间AO钢板为 3 7个月 ,单侧外固定架为 5 2个月 ,G -K钉为 2 4个月 ,感染率AO钢板为 1 3 3% ,单侧外固定架为 2 0 6 9% ,G -K钉无骨不连。关节功能障碍AO钢板为 1 1 1 % ,单侧外固定架为 2 4 1 % ,G -K钉为 2 7%。结论 G -K钉具有力学性能良 ,骨折愈合率高 ,感染率低 ,关节功能恢复良好优点 ,适于广泛推广。

Objective\ To comparatively analyze the treatment of tibial shaft fracture by using AO Plate or G-K Locking nail or single-arm external tixator and choose a better method for the clinicians. Methods\ From Jan. 1996 to Oct. 2003,110 patients (including 112 limbs) were treated with three types of fixation procedures: AO steel (46 limbs), single-arm external fixator (29 limbs), inter-locking intramedullary nail (G-K nail,37 limbs). All patients were followed-up and average union time (AUT), infective rate (IR), nonunion rate(NUR) and complications after operation were observed. Results AHT was 3 7 months in AO steel group, 5 2 months in single-arm external fixator and 2.4months in G-K nail group; IR was 13 3% in AO steel group, 20 69% in single-arm external fixator group and 2 7% in G-K nail group; NUR was 8 6% in AO steel group, 17 2% in single-arm external fixator group and no NUR in G-K nail group; joint disfuncion rate was 11 11% in AO steel group, 24 14% in single-arm external fixator group, and 2 7% in G-K nail group. Conclusions G-K locking nail′s biomechanical feature is more suitable to the tibial fracture union. It has the advantage of high union rate, low infective rate, and good recover of joint function. So it is worthy to be introduced.