交锁髓内钉治疗胫骨骨折40例临床研究

Intramedullary nailing in the treatment of tibial fractures:The clinical study of 40 cases

目的 研究交锁髓内钉治疗胫骨骨折的疗效.方法 选择2007年12月～2012年12月在我院进行手术治疗的胫骨骨折患者76例,其中行交锁髓内钉固定治疗的40例设为观察组,其余行外固定支架治疗的36例患者设为对照组,观察比较两组患者术后的优良率及骨折愈合时间、术后并发症发生率.结果 根据Johner-Wruh法进行手术的疗效评定,术后观察组的优良率达70.00％,明显高于对照组的优良率50.00％,两组优良率组间比较,差异有统计学意义（P＜0.05）;术后观察组的骨折愈合时间明显快于对照组,两组骨折愈合时间组间比较,差异有统计学意义（P＜0.05）;观察组术后出现骨延迟愈合3例,对照组术后出现骨延迟愈合5例,浅表感染4例,观察组术后并发症的发生率7.5％,对照组术后并发症的发生率25.0％,观察组术后并发症的发生率明显低于对照组,差异有统计学意义（P＜0.05）.结论 交锁髓内钉治疗胫骨骨折具有疗效确切、骨折愈合快、并发症少等优点,值得广泛推广和应用.

Objective To explore the effect of intramedullary nailing in the treatment of tibia1 fractures. Methods Se- lected 76 cases of tibial fracture patients from December 2007 to December 2012 in our hospital for surgical treat- ment, 40 cases patients were given intramedullary nail fixation for the treatment, the establishment of the observation group, the rest of the line outside the fixed stents in 36 patients, the establishment of the control group, the good rate and fracture healing time, incidence of postoperative complications were compared between two groups. Results Ac- cording to Johner＇Wruh method for assessment of the efficacy of surgery, postoperative excellent rate of observation group was 70.00%, was significantly higher than the controp group （50.00%） , the difference was statistically signifi- cant（P 〈 0.05）; postoperative fracture healing time of the observation group was significantly faster than the control group,the difference was statistically significant （P 〈 0.05）; the observation group postoperative delayed union three cases, the control group of patients after a delayed bone healing in 5 cases, 4 cases of superficial infection, postopera- tive complications of observed occurrence rate was 7.5% , the incidence of postoperative complications of the control group was 25.0% , the incidence rate of postoperative complications in the observation group was significantly lower than the control group （P 〈 0.05）. Conclusion Intramedullary nailing of tibial fractures has curative effect, fast fracture healing, fewer complications, should be popularized and applied.