两种固定方法治疗闭合性胫腓骨骨折的疗效比较

Comparison of Therapeutic Effect on Closed Tibial and Fibular Fracture with Two Different Internal Fixation Methods

目的比较AO加压钢板内固定与髓内交锁钉内固定方法治疗闭合性胫腓骨骨折的疗效。方法选取从2006年12月至2011年12月我科治疗的闭合性胫腓骨骨折共100例,其中AO加压钢板30例,交锁钉70例;对两种内固定方法的临床疗效进行比较分析。结果随访6～12个月,平均8个月。疗效优良率:AO钢板为93.4%,交锁钉为97.1%。并发症:①延迟愈合:交锁钉1例,AO加压钢板3例;②感染:AO加压钢板2例,交锁钉1例;③骨不连:AO加压钢板3例,交锁钉0例;④畸形愈合:AO加压钢板2例,交锁钉0例。结论在治疗闭合性胫腓骨骨折中,交锁钉优于AO钢板;交锁钉损伤小、并发症相对少、骨折愈合较好;AO钢板应慎用于胫骨中下1/3段骨折。

Objective To compare the therapeutic effect of two different internal fixation methods in the treatment of closed tibial and fibular fracture. Methods 100 cases of tibial and fibular fracture from December 2006 to December 2011 were selected, including 30 cases of AO compressed steel plates and 70 cases of intramedullary interlocking nail. The curative effects of two methods were compared and analyzed. Results All cases were followed-up for 6 - 12 months, with average followed-up period of 8 months. The excellence and good rate was 93.4% in AO compressed steel plates and 97.1% in intramedullary interlocking nail. The postoperative complications were as follows： ①Delayed union in 4 cases including one case in intramedullary interlocking nail, 3 cases in AO compressed plates. ②Infection in 3 cases including 2 cases in AO compressed plates and one case in intramedullary interlocking nail. ③Fracture nonunion in 3 cases including 3 in AO compressed plates and none in intramedullary interlocking nail. @Malunion in 2 cases including 2 cases in AO compressed plates and none in intramedullary interlocking nail. Conclusions The therapeutic effect of closed tibial and fibular fracture treated by intramedullary interlocking nail is more satisfied than by AO compressed plates. The intramedullary interlocking nail is considered as an effective means of treatment of tibial and fibular fracture with little hurt of operation, rare complications and good anatomy reposition. It should be careful that the fracture of 1/3 middle and lower segment of the tibia is treated by AO plate.