高龄胫骨远端粉碎性骨折患者的手术治疗经验总结

Experience summary of the surgical treatment of tibial distal comminuted fracture for aged patients

目的总结高龄胫骨远端粉碎性骨折的手术治疗经验。方法以2011年6月至2012年6月于我院接受手术治疗的62例高龄胫骨远端粉碎性骨折患者为研究对象,A组(28例)采取外支架固定治疗,B组(34例)采取经皮微创钢板固定治疗,观察记录两组的手术时间、手术出血量、骨折愈合时间和并发症,比较两种手术的疗效。结果 B组的手术时间、手术出血量和骨折愈合时间为(78.6±12.6)min、(226.4±21.6)ml和(6.5±1.4)个月,上述指标均优于A组(P<0.05);B组Johner-Wruhs评定优良率91.18%,A组优良率71.43%,组间比较差异显著(χ~2=4.10,P=0.043);A组并发症发生率10.71%,B组并发症发生率5.88%,组间比较差异无统计学意义(P>0.05)。结论经皮微创钢板固定在高龄胫骨远端粉碎性骨折中的疗效显著,安全性高,值得临床推广应用。

Objective To summarize surgical treatment experience of tibia distal comminuted fracture of the aged patients.Methods During June 2011 and June 2012, 62 cases of aged patients suffering tibial distal comminuted fracture and received surgery treatment in our hospital, were chose as the research object. A group （28 cases） treated with external stent fixation, B group （34 cases） treated with percutaneous minimally invasive plate fixation, observed and record operation time, blood loss, fracture healing time and complications of the two groups, compared the curative effect of two kinds of surgery. Results The operative time, surgical blood loss and fracture healing time of group B were （78.6±12.6） min and （226.4±21.6） ml and （6.5±1.4） months, these indicators were better than group A （P〈0.05）. Johner-Wruhs rate in group B was 91.18%, and it was 71.43% in group, the difference was statistically significant between groups （Х^2= 4.10, P = 0.043 ）. The complication rate was 10.71% in group A, and incidence of complications in group B was 5.88%, difference between groups have no statistical significance （P〉0.05）. Conclusions Percutaneous minimally invasive plate fixed in the treatment of tibia distal comminuted fracture has distinct curative effect, with high safety, worthy of clinical popularization and application.