普通钢板内固定治疗胫骨骨折并发症原因分析

Analysis of factors on complication in the treatment of tibial fractures by internal fixation with common steel plate

目的分析普通钢板内固定治疗胫骨骨折术后骨不连的发生原因与治疗对策。方法自1998年7月～2005年12月共收治胫骨骨折患者182例,全部采用普通钢板内固定治疗,术后平均随访14个月(12～18个月)。结果182例中有175例达到临床愈合标准,并已拆除钢板,未发生骨髓炎、再骨折等并发症。经X线片检查,骨折均为骨性愈合,骨折临床愈合时间12～16周,平均14周。7例未达到临床愈合标准,发生率为3.85%,患者同时合并有腓骨骨折,主要并发症为术后骨不连。结论普通钢板内固定目前仍是基层医院治疗胫骨骨折的有效方法,只要严格掌握适应症,熟练掌握操作规程,可以减少并发症,提高疗效。

Objective To analyse the pathogensis and therapeutic strategy to the postoperative nonunion in the treatment of tibial fractures through internal fixation with common steel plate. Methods From July 1998 to Dec 2005, 182 cases of tibial fractures were treated through internal fixation with common steel plate. All the cases were followed up for 12 to 18 months （averaging 14 months）. Results 175 of 182 cases got clinical healing standard and removed plate without osteomyelitis and refracture happening. Bone union were demonstrated in all cases by x-ray. The clinical healing time was 12 to 16 weeks （averaging 14 weeks）. 7 cases （3.85%） who suffered postoperative nonunion were the patients with tibiofibular fractures. Conclusion Internal fixation with common steel plate is still a safe and effective technique in the treatment of tibial fracture in the primary hospitals. Rigorous command adaptation and regulation of operation can reduce complication and advance curative effect.