对比应用扩髓与非扩髓带锁髓内钉治疗胫骨开放性骨折

CLINICAL CONTRADISTINCTION OF ENLARGING&NON-ENLARGING LOCKED BONE NAIL ON CURING COMPOUND FRACTYRE OF TIBIA

为探讨扩髓与非扩髓带锁髓内钉治疗胫骨开放性骨折的疗效差异。将65例胫骨开放性骨折随机分为两组,扩髓组30例用扩髓带锁髓内钉内固定治疗,非扩髓组35例用非扩髓带锁髓内钉内固定治疗。对比两种方法术中包括手术时间、失血量、锁钉失误、钻头断裂、医源性骨折及术后并发症包括伤口感染,骨折畸形愈合、延迟愈合、不愈合数,锁钉断裂、髓内钉静力改动力数的发生率,以评价两种方法的差异。结果显示两种方法术中并发症、手术时间、术中失血量方面比较,有显著性差异(P<0.05);其他无明显差异(P>0.05)。术后并发症中感染率比较无显著差异(P>0.05),其他有明显差异(P<0.05)。表明在彻底清创的基础上,扩髓带锁髓内钉内固定治疗胫骨开放性骨折并不会增加感染率,而且可以减少术中、术后并发症。

To approach discrepancy of therapeutic effect on enlarging & non-enlarging locked bone nail on curing compound fracture of tibia. 65 cases of patients with compound fracture of tibia were randomly divided into two groups, group A (30 cases, cured by enlarging locked bone nail) and group B (35 cases, with non-enlarging locked bone nail ). Such items of two methods as operation times, volumes of blood loss, lapsus and abruptly of lockpin, medicine source nature fracture were observed. So did those of postoperative complications including wound infection, malunion, late healed, disunion of fracture, lockpin break, changes of bone nail from static force to motivation. They were contrasted to estimate the difference. It showed there had significant difference on such items as postoperative complications, operation times and volumes of blood loss in two groups (P<0.05), and nothing in others (P>0.05). There had no obviously discrepancy on infection rates of postoperative complications in both groups (P<0.05), and manifest in others (P<0.05). It indicated that on the base of debriding thoroughly, the method of enlarging locked bone nail on curing compound fracture of tibia could not increase infection rates but decrease meta-and post-operative complications.