ETN结合阻挡钉和LCP治疗胫骨下段骨折的疗效对比

Comparison of Efficacy of ETN Combined with Blocking Nail and LCP in the Treatment of Lower Tibial Fracture

目的:比较专家型胫骨交锁髓内钉(ETN)结合阻挡钉与经皮胫骨远端锁定加压钢板(LCP)治疗胫骨下段骨折的临床效果。方法:选取本院2014年3月-2016年1月收治的胫骨下段骨折患者84例,按照随机数字表法分为ETN组与LCP组,各42例,ETN组采用ETN结合阻挡钉固定,LCP组采用LCP固定,比较两组手术指标、术后恢复情况及并发症情况。结果:两组手术时间、术中出血量及术后肿胀消退时间比较,差异均无统计学意义(P>0.05);ETN组切口愈合等级、骨折临床愈合时间、踝关节功能评分均优于LCP组,差异均有统计学意义(P<0.05);ETN组出现切口感染、骨筋膜室综合征、骨折延迟愈合或不愈合等并发症情况均少于LCP组(P<0.05),但ETN组骨折畸形愈合例数多于LCP组(P<0.05),ETN组并发生症发生率低于LCP组(16.67%vs 35.71%),差异有统计学意义(P<0.05)。结论:ETN结合阻挡钉治疗胫骨下段骨折相比于LCP技术骨折愈合时间短,切口愈合好,并发症少,值得临床推广。

Objective：To compare the clinical effect of expert tibial interlocking intramedullary nail（ETN） combined with blocking nail and percutaneous tibial distal locking plate（LCP） in the treatment of lower tibial fracture.Method：84 cases of lower tibial fracture were treated in our hospital from March 2014 to January 2016,according to the random number table method,they were divided into ETN group and LCP group,42 cases in each group.ETN group was treated with ETN combined with blocking nail,LCP group was treated with LCP,and the operation index,postoperative recovery and complication of two groups were compared.Result：The operation time,intraoperative blood loss and postoperative swelling regression time of two groups were compared,the differences were not statistically significant（P0.05）.The incision healing grade,fracture healing time and ankle function score of ETN group were better than those of LCP group（P0.05）.The incisional infection,osteofascial compartment syndrome,delayed union or unhealed complications of ETN group were less than those of LCP group（P0.05）,but the number of malunion of fracture of ETN group was more than that of LCP group（P0.05）,the total incidence of fracture of ETN group was better than that of LCP group（16.67% vs 35.71%）,the difference was statistically significant（P0.05）.Conclusion：ETN combined with blocking nail in the treatment of lower tibial fractures is shorter than that of LCP.The incision is healed well,the complication is less,and deserves clinical promotion.