切开复位内固定和交锁髓内钉内固定对胫骨骨折的效果差异性分析

Analysis of the Difference in the Effect of Open Reduction and Internal Fixation and Interlocking Intramedullary Nails on Tibial Fractures

目的探讨切开复位内固定和交锁髓内钉内固定对胫骨骨折的效果差异性。方法选取2019年3月—2020年5月期间该院收治的94例胫骨骨折患者作为研究对象,根据抽签法随机分为对照组和观察组,每组47例。对照组患者采用切开复位内固定术治疗,观察组患者采用交锁髓内钉内固定术治疗,比较两组患者手术指标、住院时间和骨折愈合时间,治疗前后踝关节功能(Kofoed)评分以及术后并发症发生率。结果观察组患者手术用时(70.42±3.65)min、术中失血量(168.85±12.13)mL、切口长度(8.85±2.36)cm、住院时间(11.25±1.62)d、骨折愈合时间(16.74±2.36)周优于对照组,差异有统计学意义(t=18.583、16.142、11.169、12.452、9.916,P<0.05);治疗后观察组患者Kofoed疼痛、功能、活动度评分(46.55±2.42)分、(26.42±1.23)分、(16.44±1.53)分高于对照组,差异有统计学意义(t=12.910、14.357、3.329,P<0.05);观察组患者术后并发症发生率为6.38%低于对照组23.40%,差异有统计学意义(χ^(2)=5.371,P<0.05)。结论交锁髓内钉内固定术对胫骨骨折疗效确切,安全性高,可有效促进患者踝关节功能的恢复,因此可用于临床推广。

Objective To explore the difference in the effect of open reduction and internal fixation and interlocking intramedullary nailing on tibial fractures.Methods Ninety-four patients with tibial fractures admitted to the hospital from March 2019 to May 2020 were selected as the research objects.According to the lottery method,they were randomly divided into a control group and an observation group,with 47 cases in each group.Patients in the control group were treated with open reduction and internal fixation,and patients in the observation group were treated with interlocking intramedullary nail internal fixation.The operation indexes,hospital stay and fracture healing time of the two groups were compared,and the ankle joint function(Kofoed)scores,and the incidence of postoperative complications before and after treatment were compared.Results The operation time of patients in the observation group was(70.42±3.65)min,intraoperative blood loss(168.85±12.13)mL,incision length(8.85±2.36)cm,hospitalization time(11.25±1.62)d,fracture healing time(16.74±2.36)week was better than the control group,and the difference were statistically significant(t=18.583,16.142,11.169,12.452,9.916,P<0.05);after treatment,the observation group had Kofoed pain,function,and mobility scores(46.55±2.42)points,(26.42±1.23)points,(16.44±1.53)points was higher than the control group,and the difference were statistically significant(t=12.910,14.357,3.329,P<0.05);the postoperative complications rate was 6.38%of the observation group was lower than that of the control group by 23.40%.The difference was statistically significant(χ^(2)=5.371,P<0.05).Conclusion Interlocking intramedullary nail internal fixation has a definite effect on tibial fractures,high safety,and can effectively promote the recovery of the patient’s ankle joint function,so it can be used for clinical promotion.