腓骨偏心性固定与中心性固定对胫骨远期愈合率的影响

Effects of Eccentric Fixation and Central Fixation of Fibula on Long-Term Healing Rate of Tibia

目的探讨腓骨偏心性固定与中心性固定对胫骨远期愈合率的影响。方法选取55例胫腓骨骨折患者,按腓骨治疗方式不同分为A组(29例)、B组(26例),2组患者均采用髓内钉中心性固定胫骨骨折,其中A组腓骨行髓内钉内固定术,B组腓骨行钢板内固定术。比较2组患者手术时间、术中出血量、住院时间、胫骨远期愈合时间、胫骨不愈合率及术后随访时间。结果 2组患者均随访6～10个月,术后A组无骨折不愈合患者,B组胫骨骨折不愈合患者4人,其余患者均取得较满意临床效果,A组患者手术时间、术中出血量、住院时间、胫骨愈合时间及胫骨不愈合率均低于B组(P<0.05)。结论 2组胫腓骨骨折治疗效果均较为满意,但应用髓内钉中心性固定患者创伤小,A组胫骨骨折远期愈合率较B组高。

Objective To investigate the effects of eccentric fixation and central fixation of fibula on the long term healing rate of tibia. Methods 55 cases of tibiofibular fractures patients were divided into A group(29 cases)and B group(26 cases)according to the fibula treatment.Patients in two groups were given intramedullary nail central fixation.Patients in group A were given fibula intramedullary nail fixation,and patients in group B were given fibula plate fixation.Operative time,intraoperative bleeding volume,hospital stay,long-term tibial healing time,tibial nonunion rate and postoperative follow-up time were compared between two groups. Results All patients were followed up for 6 to 10 months.There were no nonunion patients in group A,but in group B,four nonunion patients were found and the other patients had satisfactory clinical results.Perative time,intraoperative bleeding volume,hospitalization time,tibial union time and tibial nonunion rate in group A were lower than those in group B( P <0.05). Conclusion Both groups achieved satisfactory results,but patients treated with intramedullary nail central fixation were less traumatic.Compared with group B,group A had better long-term healing rate of tibial fracture.