带锁髓内钉和钢板螺钉固定治疗胫骨干骨折疗效观察

Effect comparison between plate screw and locked intramedullary nailing in treatment of tibial diaphysis fractures

目的观察比较带锁髓内钉和钢板螺钉固定治疗胫骨干骨折的临床疗效。方法选取2011年7月—2013年6月在本院骨外科进行手术治疗的胫骨干骨折患者116例,按照手术方式不同分成观察组60例与对照组56例,观察组采取带锁髓内钉内固定手术方式,对照组采取钢板螺钉内固定手术方式,比较2组患者手术情况、并发症发生率、骨折愈合优良率、术后具体疗效。结果观察组手术时间(83.64±16.32)min、术中出血量(153.69±40.25)mL、术后住院时间(20.29±3.46)d、出现骨痂时间(2.78±0.86)月、负重时间(2.76±0.83)月、骨折愈合时间(4.17±1.34)月、去除内固定时间(13.34±3.96)月均明显低于对照组;2组术后骨折愈合优良率、并发症发生率比较差异无统计学意义。结论带锁髓内钉治疗胫骨干骨折可达到与钢板螺钉固定相当的手术效果,但创伤更小,愈合更快,在严格掌握适应证基础上,可作为优先选择的手术方案。

Objective To compare effect of plate screw and locked intramedullary nailing on treatment of tibial diaphysis fractures.Methods 116 patients with tibial diaphysis fractures were divided into observation group and control group.Observation group was given intramedullary nails fixation,control group was given plates internal fixation.Operation index,treatment effect,fracture healing,complications were compared.Results In the observation group,operation time was（83.64±16.32）min,intraoperative blood loss was（153.69±40.25）,postoperative length of hospital stay was（20.29±3.46）days,callus duration was（2.78±0.86）months,weight time was（2.76±0.83）months,fracture healing time was（4.17±1.34）months,removing internal fixation time was（13.34±3.96）months,which were significantly lower than control group.There were no significant differences of postoperative fracture healing fine rate,incidence of complications between two groups.Conclusion Intramedullary nails fractures can be achieved with steel plates internal fixation for treatment of tibial diaphysis fractures surgery effect,but smaller trauma,healing faster,on the basis of strictly grasp the indications,it can be used as a good operation method.