胫骨下段骨折切开与闭合复位内固定术疗效比较

Therapeutic effect of internal fixation after open and closed reduction for distal tibial fracture

目的比较闭合性胫骨下段骨折切开复位与闭合复位内固定术的疗效,以期寻找更合适的治疗手段。方法对50例胫腓骨下段骨折行内固定术,随机分为2组:A组25例(闭合复位、经皮锁定加压接骨板内固定)、B组25例(切开复位、锁定加压接骨板内固定)。结果 A组平均手术时间较B组长、术中透视次数多、解剖复位率低,但平均术中出血量少、切口长度短、住院时间短、骨折临床愈合时间短、下地负重时间短、术后并发症发生率低、术后Johner-Wruhs评分优良率高,两组差异均有统计学意义(P<0.05)。结论对于胫骨下段闭合性骨折,采用闭合复位、经皮胫骨内侧锁定加压接骨板内固定术总体疗效优于切开复位、胫骨内侧锁定加压接骨板内固定术,可以推广使用。

Objective To compare the therapeutic effect of open and dosed reduction and internal fixation for the treatment of distal tJbial fracture, in order to Find a more appropriate treatment method. Methods Fifty cases of internalfixation for tibia and fibula fracture,in this prospective study, were randomly divided into two groups：group A （dosed reduction, percutaneotm locking compression plate internal fixation）, group B （open reduction and locking compression plate internal fixation）. Results Compared with group B, group A had longer opemt/on time, more X-ray exam/nat/on, and lower anatomical reduet/on rote, but with less bleeding during operation, the shorter average wound, shorter averagehospitalization time, shorter average healing time, leas postoperative complications, average weight bearing sooner atier operation, higher good and excellent rate with Johner-Wmhs evaluation.There was significant difference in the two group （P 〈0.05）. Conclusion The distal tibial fraeture with closed reduction, and medial tibial locking compression plate internal Fixation method is better than that of open reduction and internal fixation of tibial locking compression plate, and it can be spreaded.