矩形髓内钉与接骨板治疗胫骨中下1/3骨折疗效对比分析

Comparative Study on Effect of Rectangular Intramedullary Nail and Bone Fracture Plate for the one-third lower Tibial Fracture

目的 :比较矩形髓内钉与接骨板内固定治疗胫骨中下 1/ 3骨折的临床效果 ,筛选出一种较为理想的内固定手术方法。方法 :对我院 90年 1月～ 98年 12月收治的胫骨中下 1/ 3骨折采取两种不同内固定手术的 2 16例病人的临床资料进行归纳总结 ,统计学分析。结果 :接骨板组 10 2例 ,骨折平均愈合时间 71.5天 ,优良率 2 3.5 % ,延迟愈合率5 5 .88% ,不愈合率 2 0 .5 9%。而矩形髓内钉组共 114例 ,骨折平均愈合时间 5 0 .4天 ,优良率 86 .84%。结论 :胫骨中下1/ 3骨折内固定术后并发骨延迟愈合及不愈合率较高 ,矩形髓内钉内固定治疗胫骨中下 1/ 3骨折优良率高 ,延迟愈合及不愈合率低 ,明显优于接骨板内固定手术。

Objective:To compare the clinical effects of the rectangular intramedullary nail and bone plates for the one third lower tibial fracture and choose a better internal fixation treatment.Methods:216 cases of the one-third lower tibial fracture in our bospital from Jan,1990 to Dec,1998 were treated with these two different intern fixations.And their records were summed up and analysed statistically.Results:In the bone plate group of 102 cases,the average union time was 71.5 days.The excellent and good rate was 23.5%,the delayed union 55.88% and the ununion 20.59% respectively.In the rectangular intramedullary nail group of 114 cases,the average union time was 50.4 days.The excellent and good rate was 86.84%,the delayed union 12.28% and the ununion rate 0.88% respectively.Conclusion:The rates of the delayed union and ununion,complicated by the internal fixation for the one third lower tibial fracture,were higher.The rectagular intramedullary nail internal fixation for the one third lower bibial fracture had a higher union rate and was obviously better than the bone plates.The rates of delayed union and ununion were lower.