高原地区有限切开复位内固定治疗胫腓骨骨折疗效分析

Treatment of Tibiofibular Fractures by Limited Open Incison and Internal Fixation in Plateau

目的比较闭合与有限切开复位内固定治疗胫腓骨骨折的临床疗效,对比患者骨愈合时间及术后并发症情况。方法回顾我院骨科在2014年2月~2016年6月诊治60例胫腓骨骨折患者的临床资料,根据治疗方式分为两组,A组闭合复位内固定,B组有限切复位内固定,对比两组的手术时间、术中出血量、骨折愈合时间、术后并发症情况,并采用Johner-Wruhs评分标准对末次随访时关节功能进行评价。结果两组患者均获得随访,A组手术时间及术中出血量较B组少(P<0.05),B组骨折愈合时间短于A组(P<0.05)。两组术后疗效Johner-Wruhs评分优良率差异无统计学意义(P>0.05)。A组患者骨折延迟愈合发生率和B组比较有统计学差异(P<0.05),两组均未出现皮肤感染等情况。结论有限切开没有加重断端血运毁损,且骨折面得到了很好的复位,有利于骨折愈合,且术后并发症并没有增加,适合高原特殊地区应用。

Objective To compare the clinical curative effect of closed and limited open incison and internal fixation for the treatment of tibiofibular fractures and to compare the time of bone union and postoperative complications.Methods Retrospectively analyzed the clinical data of 60 patients with tibiofibular fractures who were diagnosed and treated in orthopedics department from February 2014 to June 2016.The patients were divided into two groups according to the mode of treatment.Group A received closed reduction and internal fixation while group B received limited reduction and internal fixation.The operation time,intraoperative blood loss,fracture healing time and postoperative complications were compared between two groups.The Johner-Wruhs score was used to evaluate the joint function at the final follow-up.Results Both groups were followed up.The operation time and blood loss in group A were less than those in group B(<0.05).The fracture healing time in group B was shorter than that in group A(<0.05).There was no significant difference between the two groups in the Johner-Wruhs score(>0.05).The incidence of delayed union of fractures in group A was significantly higher than that in group B(<0.05).No skin infections were observed in both groups.Conclusion The limited incision did not aggravate the damage of the blood supply to the stump,and the fracture surface was well reset,which is good for the fracture healing,and the postoperative complications did not increase,which is suitable for the special plateau application.