扩张自锁髓内钉与锁定钢板置入治疗胫骨干闭合骨折的比较

Self-locking expandable intramedullary nail versus locking plate in the treatment of closed tibial shaft fractures

背景:采用扩张自锁髓内钉置入治疗简单闭合性骨折具有操作简单,无需交锁等优势。目的:对比扩张自锁髓内钉置入内固定与锁定钢板置入内固定治疗胫骨干闭合骨折的临床效果。方法:分别采用自锁髓内钉与锁定钢板置入内固定治疗胫骨闭合性骨折。记录两组手术时间、出血量、术中与术后并发症、下地时间、骨折愈合时间、置入后1年膝关节KSS评分结果。结果与结论:自锁髓内钉组手术时间、出血量均低于锁定钢板内固定组(P<0.05)、下地时间快于锁定钢板内固定组(P<0.05),两组术中与术后并发症发生率、骨折愈合时间、置入后1年膝关节KSS评分及生物相容性差异无显著性意义。提示采用髓内扩张自锁髓内钉置入治疗胫骨干闭合骨折更微创,具有手术时间短,下地时间早等优势。

BACKGROUND：Because the operation technique of self-locking expandable intramedullary nail is relatively simple,it has some advantages in the treatment of simple closed tibial fracture.OBJECTIVE：To investigate and discuss the feasibility and clinical outcome of self-locking expandable intramedullary nail versus locking plate in the treatment of closed tibial shaft fracture.METHODS：In self-locking expandable intramedullary nail group,15 cases were operated.In locking plate group,16 cases were operated.Time of operation,the intra-operative blood loss,the rate of complications,time of leave bed,time of bone union,the KSS score of the knee were recorded.RESULTS AND CONCLUSION：The time of operation and intra-operative blood loss in self-locking expandable intramedullary nail group were lower than those in locking plate group（P 0.05）,while the time of leave bed was shorter in the self-locking expandable intramedullary nail group（P 0.05）.There were no statistical differences in the perioperative or postoperative complications,the time of bone union,and the KSS score of the knee in the two group.It may be an appropriate technique for using self-locking expandable intramedullary nail to treat closed tibial shaft fracture.