尖头梅花髓内针与带锁髓内针治疗胫腓骨骨折比较

A Comparative Analysis the of Treatment of both tibia and fibula Fracture with improved apex plum-shaped intramedullary nail or intramdullar interlocking nail

目的 比较改良的尖头梅花针与带锁髓内针治疗胫腓骨干骨折的临床综合疗效 ,正确选取内固定物。方法 分别用改良的尖头梅花针与带锁髓内钉内固定治疗胫腓骨干骨折 74例 ,比较两组的综合疗效。结果 改良梅花针组 48例 ,轻度外旋畸形 2例 ,无骨不愈合 ,平均骨折愈合时间 3.5个月 ,平均手术时间 40 mim ,住院费用 30 0 0元 (人民币 ) ,优良率93.75 % ;带锁髓内钉组 2 1例 ,发生骨延期愈合 2例 ,平均骨折愈合时间 5个月 ,平均手术时间 6 0 mim ,住院费用 5 5 0 0元(人民币 ) ,优良率 95 .2 4%。除胫骨远端下 1/ 3或严重的粉碎性骨折外 ,两组疗效无明显差异 (P >0 .0 5 )。结论 改良尖梅花针内固定操作简单、价格低廉、疗效确切 ,仍有较高的临床使用价值 ;带锁髓内钉能满足胫骨各种类型的骨折 ,扩大了髓内固定的适应症 ,随着成本的降低 ,已逐渐成为治疗胫腓骨骨折髓内固定的方向。

Objectiv To compare the respective clinical extensive effects of both tibia and fibula with improved apex plum shaped intramedullary nail or intramedullary interlocking nail,and choice correctly internal fixations Methods treated 74 patients of fracture of both tibia and fibula with improved apex plum shaped intramedullary nail or intramedullary interlocking nail,then compared respective clinical extensive effects Results The group of improved apex plum shaped intramedullary in all 48 cases,the fractures healed up well except cases with light extemal rotation of leg The average fracture healing time 3 5 months The average surgery time 40 minutes The hospitalization expenses 3000RMB The successful clinical outcome was 93 75% The group of intramedullary interlocking nail in all 21 cases,2 cases showed delay union,The average fracture healing time 5 months,The average surgery time 60 minutes The hospitalization expeses 5500RMB,The successful clinical outcome was 95 24% The curate effects of two groups have no apparent difference except treating tibia fracture at lower third position or serious comminuted fracture(P>0 05) Conclusions The improved apex plum shaped intramedullary nail has benefit of simple performance , cheep price , great curative effects , so it has high clinical application value , The intramedullary interlocking nail can content treatment on varieties of tibia fracture and enlarge the indication of intramedullary railing with lowering price , it is becoming thg intramedullary fixation direction of treating of treating of both tibia and fibula