钛制弹性髓内钉内固定术治疗中段胫骨创伤性骨折患儿的临床效果及对术后康复的影响

Clinical observation of titanium elastic intramedullary nail in treatment of middle tibial traumatic fracture and its effect on postoperative rehabilitation

目的探讨钛制弹性髓内钉内固定术治疗中段胫骨创伤性骨折患儿的临床效果及对术后康复的影响。方法选取2017年6月—2019年1月成都市第七人民医院91例中段胫骨创伤性骨折患儿为研究对象,患儿行骨折修复手术。采用随机分组将所有患儿分为传统内固定组(45例,复位锁定加压钢板内固定术)和弹性髓内钉组(46例,钛制弹性髓内钉内固术),比较两组患儿的骨折修复率、疗效观察指标、骨痂生长情况,以及不良反应和并发症发生率。结果弹性髓内钉组的骨折修复优良率高于传统内固定组(P<0.05);住院时间、骨折线消失时间、骨骼愈合时间、手术时间短于传统内固定组(P<0.05);术中失血量少于传统内固定组(P<0.05);骨痂生长情况评分高于传统内固定组(P<0.05)。不同时间点的骨痂生长情况评分有差异(P<0.05),两组的骨痂生长情况评分有差异(P<0.05),两组的骨痂生长情况评分变化趋势有差异(P<0.05)。(3)弹性髓内钉组的不良反应和并发症的总发生率(6.52%)明显低于传统内固定组(22.22%)(P<0.05)。结论钛制弹性髓内钉内固定术治疗中段胫骨创伤性骨折患儿的临床效果显著,与切开复位锁定加压钢板内固定方案相比,更利于骨骼愈合和骨痂生长。

Objective To explore the clinical effect of titanium elastic intramedullary nail in the treatment of middle tibial traumatic fracture and its influence on postoperative rehabilitation.Methods A total of 91 children with middle tibial traumatic fracture were divided into two groups:traditional internal fixation group(45 cases,treated with open reduction and locking compression plate internal fixation)and elastic intramedullary nail group(46cases,treated with titanium elastic intramedullary nail internal fixation).The differences of fracture recovery effect,therapeutic observation index,callus growth and safety index between the two groups were compared.Results The excellent and good rate of fracture repair,hospitalization time,fracture line disappearance time,intraoperative blood loss,bone healing time,and operation time in the elastic intramedullary nail group were shorter(or better)than those in the traditional internal fixation group(P<0.05);The callus growth score of the internal nail group was higher than that of the traditional internal fixation group(P<0.05);the change trend of the callus growth score of the traditional internal fixation group and the elastic intramedullary nail group was different(P<0.05);The elastic intramedullary nail The incidence of adverse reactions and complications in the group(6.52%)was significantly lower than that of the traditional internal fixation group(22.22%)(P<0.05).Conclusion Compared with the open reduction and locking compression plate internal fixation,titanium elastic intramedullary nail is more conducive to bone healing and callus growth.