应用单侧多功能外固定架固定与加压钢板内固定治疗胫腓骨骨折疗效对比

Efficacy comparison between the application of unilateral multifunctional external fixation and compression plate internal fixation in the treatment of fractures of tibia and fibula

目的 对比分析应用单侧多功能外固定架固定与加压钢板内固定治疗胫腓骨骨折的临床疗效.方法 选择2012年7月-2014年6月收治的胫腓骨骨折患者86例,将其随机分为观察组和对照组各43例,观察组采取切开复位,行单侧多功能外固定架固定;对照组接受加压钢板内固定治疗.术后均获6~12个月随访,观察并比较两组的手术时间、术中出血量、住院时间、骨折愈合时间、术后并发症以及术后6个月,12个月时的Johner-Wruhs评分.结果 观察组手术时间为（90.1±11.4）min,骨折愈合时间为（13.9±4.5）周,均显著低于对照组（t=4.165,2.930,P〈0.05）,而两组在术中出血量和住院时间上的比较则差异无统计学（t=1.227,1.504,P〉0.05）.观察组出现术后并发症2例（4.65%）,远低于对照组的9例（20.93%）（χ^2=5.108,P〈0.05）,未发生骨不连和畸形愈合.且观察组术后6个月、12个月时的Johner-Wruhs评分的总体优良率均显著优于对照组（χ^2=4.914,4.074,P〈0.05）.结论 应用单侧多功能外固定架固定治疗胫腓骨骨折手术操作简单、耗时短,骨折愈合快、并发症少,值得在临床上推广应用.

Objective To compare and analyze the clinical effects of the application of unilateral multifunctional external fixation and compression plate internal fixation in the treatment of fractures of tibia and fibula. Methods 86 patients with fractures of tibia and fibula were treated in our hospital from July, 2011 to February, 2013.They were randomly divided into two groups with 43 cases each. Patients of observation group were treated with open reduction and unilateral multifunctional external fixation. Patients of control group received compression plate internal fixation. Then we carried out a follow-up of 6~12 months. During this study, we observed and compared the operation time, bleeding volume during operation, hospitalization time, fracture healing time, postoperative complications and postoperative 6 months, 12 months Johner-Wruhs scores of two groups. Results There was no loss of follow-up in 86 cases.The operation time of observation group was （90.1±11.4） minutes, and the fracture healing time was （13.9±4.5）weeks.These two indexes were significantly lower than those in the control group （t=4.165,2.930,P〈0.05）.There was no significant difference between bleeding volume during operation and hospitalization time of two groups （t=1.227,1.504,P〉0.05）. 2 cases of postoperative complications occurred in observation group （4.65%） without nonunion and malunion. While 9 cases of complications occurred in control group （20.93%）（χ^2=5.108,P〈0.05）. The overall excellent rate of Johner-Wruhs scores 6 months, 12 months after operation of observation group were significantly better than the control group （χ^2=4.914,4.074,P〈0.05）. Conclusion The application of unilateral multifunctional external fixationin on the treatment of fractures of tibia and fibulahas has the advantages of simple operation procedure, short operation time, fast fracture healing and less complications. This method is worthy of promotion and application in clinics.