专家型髓内钉和锁定钢板内固定治疗胫骨下段骨折的效果及安全性对比

Clinical efficacy and security of expert tibial nail and locking plate for distal tibial fracture

目的探讨专家型髓内钉（ETN）和锁定钢板内固定治疗胫骨下段骨折的临床效果，并评价其安全性。方法选取我院2013年1月。2016年2月收治的胫骨下段骨折患者70例，按入院时间顺序随机分为两组，观察组38例，采用ETN内固定治疗，对照组32例，采用锁定钢板内固定治疗。所有患者均随访6个月，采用Merchan评分标准评价治疗效果。比较两组患者术后感染、骨折畸形愈合、螺钉松动、再骨折等并发症发生率。结果在Merchan评分中，观察组总优良率为94．7％，显著高于对照组的71．9％（P〈0．05）；观察组螺钉松动1例，总并发症发生率7．9％，显著低于对照组（P〈0．05）。结论在胫骨下段骨折治疗中，ETN内固定较锁定钢板内固定临床效果更佳，安全可靠、并发症少。

Objective To explore the clinical efficacy of expert tibial nail and locking plate for distal tibial fracture,and evaluate their security.Methods 70 patients with distal tibial fracture in our hospital from January 2013 to February 2016,were randomly dividied into two groups according to the time sequence of admission,the observation group （n=38） was treated with ETN,and the control group （n=32） was treated with locking plate.All patients were followed up for not less then 6 months.Then the Merchan criteria were used to evaluate clinical efficacy.The excellent and good rate,and complication incidence rates of infection after surgery,malunion after fracture,screw loosening and re-fracture were compared between the two groups.Results In Merchan criteria,the good rate of observation group was 94.7%,was signif- icantly higher than that of control group（71.9%）（P〈0.05）.The screw loosening（n=1） and the total incidence rate of 7.9% of the observation group were markedly lower than that of control group （P〈0.05）.Conclusion In the treatment of distal tibial fracture,ETN is more efficient in clinical efficacy thenlocking plate,and the therapy method of ETN,whieh has lit- tle complication,it is safe and reliable.