胫骨近端关节外骨折 髓内钉治疗与钢板同定治疗的比较

Extraarticular proximal-tibial fractures——Treatment with intramedullary nail versus plate fixation

比较髓内钉与钢板内固定治疗胫骨近端关节外骨折的研究很少,且质量较低.两种方法发生骨折不愈合的几率无差异.与钢板内固定相比,髓内钉治疗的患者感染发生率较低,但是骨折畸形愈合和筋膜室综合征的发生率较高.采用髓内钉治疗的患者有内固定失败的报道.通过目前的病例报道,暂时不能得出确切的结论,所以应进一步做前瞻性或随机对照研究来说明该问题.

Summary Limited, poor evidence is available for comparing the treatment of extraarticular proximal tibial fractures by intramedullary nail or plate fixation. There was no difference in the rates of nonunion for either treatment. Significantly less patients treated by intramedullary nailing experience infection than patients treated by plating, whereas more patients treated by intramedullary nailing experienced malunion or compartment syndrome than those treated by intramedullary nailing. Implant failure occurred only in patients treated by intramedullary nailing. However, definitive conclusions cannot be drawn from this collection of case-series and a well-conducted prospective or randomized controlled trial would be a significant addition to this subject.