经皮锁定桥接钢板技术与带锁髓内钉技术治疗复杂性胫腓骨骨折

A Comparison between Percutaneous Locking Bridging-plate Osteosynthesis and Interlocking Intramedullary Nail for Treatment of Complicate Tibiofibular Fracture

目的探讨经皮锁定桥接钢板技术和带锁髓内钉技术在复杂性胫腓骨骨折治疗中的临床疗效。方法选择2003年8月～2006年1月在本院治疗的胫腓骨复杂性骨折患者41例，根据手术方式不同分为2组：锁定钢板组23例，带髓内钉组18例。结合闭合复位分别对两组术中出血量、术后肿胀消退时间、骨折愈合时间、术后并发症率、术后疗效进行对比观察。结果两组手术时间、手术透视时间、住院时间、24周骨折愈合、术后并发症率、术后疗效比较差异有统计学意义（P〈0．05）。两组术中出血量、术后肿胀消退时间、12周愈合比较，差异有统计学意义（P〈0．05）。结论经皮桥接锁定钢板技术和带锁髓内钉技术都是治疗复杂性胫骨骨折的好方法，经皮桥接锁定钢板技术在治疗复杂性胫骨骨折时具有明显的优势，降低了对骨折处血运的干扰，减少了术中出血量，减轻了术后患腿肿胀程度，促进了骨折愈合。

Objective To ananyze the results of treating complicate tibiofibular fracture by percutaneous locking bridging-plate osteosynthesis and interlocking intramedullary nail, and to provide the data for the clinical application. Methods From August 2003 to January 2006, 41 patients who suffered from complicate tibiofibular fracture were divided into two groups at random. Combining indirect redution, treated by percutaneous locking bridging-plate osteosynthesis （Group A, 23 cases ）and interlocking intramedullary nail （Group B, 18 cases）. Compared them for surgery time, intraoperation heeding, fluoroscopical time, time of well-subsidese, inhospital time, fracture union rate of 12 and 24 weeks, complications rate, postoperative therapeutic effect. Results There were not significant difference in surgery time, fluoroscopical time in operation, the inhosoital time. fracture union rate of 12 weeks, the rate of complications postoperative,the postoperative therapeutic effect. There were significant difference in the intraoperation heeding, time of well-subsidese and fracture union rate of 24 weeks. Conclusion Treatment of complicate tibiofibular fracture with the percutaneous locking bridging-plate osteosynthesis and interlocking intramedullary nail are both ideal therapies. It is obvious that the percutaneous locking bridgingplate osteosynthesis in the complicate tibiofibular fractures have many advantages. It could reduce disturbing vascularization of borne fragment, decrease intraoperation beeding and the time of wellsubsideise, accelerate bone healing.