不同方法治疗胫骨中下段骨折的效果比较研究

Comparative effectiveness research of different treatment methods on middle and lower tibial fracture

目的探讨不同方法治疗胫骨中下段骨折的临床效果。方法选取2015年10月—2017年10月上饶博爱医院收治的胫骨中下段骨折患者100例,根据治疗方法不同分为C、D组,各50例。将D组分为Dc(n=18)、Dd(n=15)、De(n=17)3个亚组。C组患者接受保守治疗;D组接受手术治疗,其中Dc组接受交锁髓内钉内固定手术治疗,Dd组接受外固定支架固定手术治疗,De组接受钢板螺钉内固定手术治疗。比较两组患者及D组3个亚组骨折愈合率,并观察两组患者并发症发生情况。结果 D组患者骨折愈合率高于C组(P<0.05)。Dc、De组患者骨折愈合率比较,差异无统计学意义(P>0.05);Dc、De组患者骨折愈合率高于Dd组(P<0.05)。D组患者并发症发生率低于C组(P<0.05)。结论手术治疗胫骨中下段骨折的临床效果优于保守治疗,而交锁髓内钉内固定与钢板螺钉内固定治疗胫骨中下段骨折的临床效果优于外固定支架固定,其并不会损伤骨折端的骨膜与软组织,保证骨折端血供正常,进而促进骨折愈合。

Objective To compare the clinical effect of different treatment methods on middle and lower tibial fracture.Methods A total of 100 cases of patients with middle and lower tibial fracture were selected from October 2015 to October 2017 in Shangrao Pok Oi Hospital according to the different treatment methods,which were divided into C and D groups,50 cases each.D Group was divided into three subgroups:Dc(n=18),Dd(n=15) and De(n=17) group.C Group was received conservative treatment,D group was received surgical treatment,Dc group was received interlocking intramedullary nail fixation,Dd group was received external fixator fixation,De group was received plate and screw fixation.The fracture healing rate were compared between the two groups and three subgroups of group D.The complications of the two groups were observed.Results The fracture healing rate in D group was higher than C group(P<0.05).There was no significant difference in fracture healing rate between Dc and De groups(P>0.05).Fracture healing rate of Dc and De groups was higher than Dd group(P<0.05).The incidence rate of complications in D group was lower than C group(P<0.05).ConclusionThe clinical effect of surgical treatment is superior to conservative treatment in treating middle and lower tibial fractures,while interlocking intramedullary nail and plate and screw internal fixation are superior to external fixator fixation in the treatment of middle and lower tibial fractures,without periosteum and soft tissue damaging at the fracture end,ensure blood supply at the fracture end,and promote fracture healing.