胫腓骨远端关节外骨折钢板固定与髓内钉固定的疗效比较

Comparison of the Curative Effect between Plate Fixation and Intramedullary Nail Fixation in the Treatment of Extraarticular Fracture of Distal Tibia and Fibula

目的:比较钢板固定与髓内钉固定在胫腓骨远端关节外骨折治疗中的疗效。方法:选取2015年1月～2017年3月我院骨科收治的40例胫腓骨远端关外骨折患者作为研究对象,随机分为治疗组与对照组,每组20例。治疗组胫骨行髓内钉固定,腓骨行钢板固定;对照组胫骨和腓骨均采用钢板固定。比较两组的平均手术时间、术中平均出血量、骨折愈合时间和术后1年踝关节功能评分。结果:治疗组与对照组的平均手术时间、术中平均出血量、骨折愈合时间和术后1年踝关节功能评分相比较,差异均无统计学意义,P>0.05;但治疗组的术后并发症发生率为15.0%,低于对照组的40.0%,差异有统计学意义,P<0.05。结论:在胫腓骨远端骨折的治疗中,相较于钢板固定,髓内钉固定对软组织损伤更小,术后并发症更少。

Objective： To compare the curative effect between plate fixation and intramedullary nail fixation in the treatment of extraarticular fracture of distal tibia and fibula. Methods： From January 2015 to March 2017, 40 patients with extraarticular fracture of distal tibia and fibula received in the department of orthopedics in our hospital were randomly divided into the treatment group and the control group, each group with 20 cases. The tibia of the treatment group was fixed with intramedullary nail and the fibula was fixed with steel plate, while the tibia and fibula of the control group were both fixed with steel plate. Compared the average operation time, the mean intraoperative blood loss, fracture healing time and ankle function scores between the two groups. Results： There was no statistical significance in the difference between the two groups＇ average operation time, the mean intraoperative blood loss, fracture healing time and ankle function scores, P〈0.05; however, the incidence of postoperative complications in the treatment group was 15.0%, lower than that in the control group（40.0%）, the difference was statistically significant, P〈0.05. Conclusion： In the treatment of extraarticular fracture of distal tibia and fibula, intramedullary nail fixation has less soft tissue injury and less postoperative complications than plate fixation.