经皮微创钢板与髓内钉内固定治疗胫骨中下段骨折的效果分析

Analysis of the Effect of Percutaneous Minimally Invasive Steel Plate and Intramedullary Nail Internal Fixation in the Treatment of Middle and Lower Tibial Fractures

目的对比经皮微创钢板与髓内钉内固定治疗胫骨中下段骨折的效果。方法方便选取2019年1月—2020年12月该院收治的102例胫骨中下段骨折患者为研究对象,以随机数表法将其划分为两组。研究组51例患者行经皮微创钢板内固定术治疗,对照组51例患者行髓内钉内固定术治疗。比较两组术中情况(手术时间、术中出血量)与术后情况(离床活动时间、住院时间、骨折愈合时间)、治疗优良率,以及术后不良反应情况。结果研究组手术时间(68.52±4.50)min、术中出血量(88.65±16.52)mL、离床活动时间(9.02±1.00)d、住院时间(10.52±4.06)d、骨折愈合时间(122.50±10.54)d较对照组(83.45±4.03)min、(103.52±20.45)mL、(13.54±1.02)d、(14.42±3.55)d、(132.65±12.03)d低,差异有统计学意义(t=17.650、4.039、22.598、5.164、4.532,P<0.001)。研究组治疗优良率96.08%与对照组92.16%对比,差异无统计学意义(χ^(2)=0.177,P>0.05)。研究组术后不良反应发生率3.92%与对照组5.88%对比,差异无统计学意义(χ^(2)=0.000,P>0.05)。结论经皮微创钢板与髓内钉内固定治疗胫骨中下段骨折均具有理想的疗效与安全性,但经皮微创钢板内固定术的手术时间更短,且术中出血量少,加快了术后康复速度。

Objective To compare the effect of percutaneous minimally invasive steel plate and intramedullary nail internal fixation in the treatment of middle and lower tibial fractures.Methods 102 patients with middle and lower tibial fractures treated in the hospital from January 2019 to December 2020 were conveniently selected as the research object,and they were divided into two groups by random number table method.51 patients in the study group were treated with percutaneous minimally invasive plate internal fixation,and 51 patients in the control group were treated with intramedullary nail internal fixation.The intraoperative conditions(operating time,intraoperative blood loss)and postoperative conditions(time out of bed,hospitalization time,fracture healing time),the excellent and good rate of treatment,and postoperative reactions were compared between the two groups.Results In the study group,operation time(68.52±4.50)min,intraoperative blood loss(88.65±16.52)mL,bedtime activity time(9.02±1.00)d,hospital stay(10.52±4.06)d,fracture healing time(122.50±10.54)d were lower than the control group(83.45±4.03)min,(103.52±20.45)mL,(13.54±1.02)d,(14.42±3.55)d,(132.65±12.03)d,the difference was statistically significant(t=17.650,4.039,22.598,5.164,4.532,P<0.001).The excellent and good rate of treatment in the study group was 96.08%,compared with 92.16%in the control group,and the difference was not statistically significant(χ^(2)=0.177,P>0.05).The postoperative adrerse reactions rate in the study group was 3.92%,compared with 5.88%in the control group,and the difference was not statistically significant(χ^(2)=0.000,P>0.05).Conclusion Percutaneous minimally invasive steel plate and intramedullary nail internal fixation for the treatment of middle and lower tibial fractures have ideal efficacy and safety.However,the operation time of percutaneous minimally invasive plate internal fixation is shorter,and the amount of intraoperative blood loss is less,which speeds up the speed of postoperative recovery.