微创植入锁定钢板与切开复位钢板内固定在前臂骨干骨折治疗中的对比研究

Comparative research between minimally invasive locking plate implantation and open reduction locking plate internal fixation in the treatment of forearm shaft fracture

目的对比微创植入锁定钢板与切开复位钢板内固定在前臂骨干骨折治疗中的效果差异,为今后的手术方式选择提供参考依据。方法 80例前臂骨干骨折患者作为本组研究的观察对象,根据手术方式将其分为对照组与观察组,各40例。对照组采用传统切开复位加压钢板内固定手术,观察组采用微创植入锁定钢板手术。分别于手术前与手术后3个月对两组的前臂功能进行对比评价,并观察两组的术后感染以及骨折愈合情况。结果 1治疗后3个月,观察组中前臂功能优13例,良24例,差3例,治疗优良率为92.5%;对照组中前臂功能优7例,良22例,差11例,治疗优良率为72.5%;观察组治疗优良率明显高于对照组,差异具有统计学意义(P<0.05)。2观察组共发生术后感染3例(7.5%),骨折愈合38例(95.0%);对照组共发生术后感染7例(17.5%),骨折愈合33例(82.5%),观察组术后感染及骨折愈合情况均明显优于对照组,差异具有统计学意义(P<0.05)。结论微创植入锁定钢板治疗前臂骨干骨折可以有效改善患者前臂功能,骨折愈合理想,而且术后感染率低,可以作为前臂骨干骨折的首选手术方法在临床中推广应用。

Objective To compare difference of effect between minimally invasive locking plate implantation and open reduction locking plate internal fixation in the treatment of forearm shaft fracture, and to provide reference for further choice of operation measure. Methods A total of 80 patients with forearm shaft fracture as study subjects were divided by different operation measures into control group and observation group, with 40 cases in each group. The control group received conventional open reduction combined with locking plate internal fixation in operation, and the observation group received minimally invasive locking plate implantation in operation. Evaluation of forearm function was made before and in 3 months after operation in both groups, and observation was made on postoperative infections and fracture healing. Results （1） In 3 months after treatment, there were 13 cases with excellent forearm function, 24 good cases and 3 poor cases in the observation group, with the total good rate as 92.5%. While in the control group, there were 7 excellent cases, 22 good cases and 11 poor cases, with the total good rate as 72.5%. The observation group had much higher total good rate than the control group, and the difference had statistical significance （P〈0.05）. （2） There were 3 cases （7.5%） with postoperative infection and 38 cases （95.0%） with healed fracture in the observation group. In the control group, there were 7 cases （17.5%） with postoperative infection and 33 cases （82.5%） with healed fracture. The observation group had obviously better condition of postoperative infection and fracture healing than the control group, and their difference had statistical significance （P〈0.05）. Conclusion Minimally invasive locking plate implantation can effectively improve forearm function in treating forearm shaft fracture, along with ideal fracture healing and low incidence of postoperative infection. This method can be promoted and applied as the preferred clinical method for operation.