切开复位内固定与有限切开外固定架治疗胫骨远端骨折的对比研究

Comparison of Limited Open Reduction and External Fixation and Open Reduction and Internal Fixation in Distal Tibia Shaft Fractures

目的评价有限切开外固定架和切开复位内固定治疗胫骨远端骨折的临床疗效与对比研究。方法选取2015年1月—2017年3月收治90例胫骨远端骨折患者作为研究对象。采取随机分配原则分为两组:内固定组(45例)行切开复位内固定治疗,外固定组(45例)行有限切开复位外固定架治疗。对比分析两组患者的手术时间、术后并发症、骨折愈合时间、恢复工作时间进行统计学比较。结果随访时间6～12个月。内固定组平均手术时间为(115.8±15.6)min,超过外固定组的(83.3±15.8)min,差异具有统计学意义(P<0.05)。内固定组术后并发症7例,外固定组3例,内固定组术后并发症发生率为15.6%,高于外固定组的6.7%,差异具有统计学意义(P<0.05)。平均骨折愈合时间内固定组为(6.9±1.5)个月,外固定组为(6.0±1.8)个月,差异无统计学意义(P>0.05)。内固定组恢复工作时间为(7.5±3.2)个月,与外固定组(6.5±2.4)个月对比,差异有统计学意义(P<0.05)。结论有限切开复位外固定架治疗胫骨远端骨折与切开复位内固定相比更安全、有效。

Objective To evaluate the clinical efficacy and comparative study of limited open reduction external fixator and open reduction and internal fixation in the treatment of distal tibial fractures.Methods From January 2015 to March 2017,90 patients with distal tibial fractures were selected as the research subjects.The internal fixation group(45 cases)underwent open reduction and internal fixation.The external fixation group(45 cases)underwent limited open reduction and external fixation.The operative time,postoperative complications,fracture healing time and recovery time of the two groups were compared and analyzed statistically.Results The follow-up period was 6~12 months.The average operation time of the internal fixation group was(115.8±15.6)min,which was significantly higher than that of the external fixation group(83.3±15.8)min,the difference was statistically significant(P<0.05).There were 7 cases of postoperative complications in the internal fixation group and 3 cases in the external fixation group.The postoperative complication rate was 15.6%in the internal fixation group,which was significantly higher than the 6.7%in the external fixation group,the difference was statistically significant(P<0.05).The average fracture healing time was(6.9±1.5)months in the fixed group and(6.0±1.8)months in the external fixation group,the difference was not statistically significant(P>0.05).The recovery time of the internal fixation group was(7.5±3.2)months,and compared with the external fixation group(6.5±2.4)months,the difference was statistically significant(P<0.05).Conclusion Limited open reduction and external fixation for distal tibial fractures is safer and more effective than open reduction and internal fixation.