髓内钉和微创经皮钢板内固定对胫骨远端骨折患者临床指标及并发症情况的影响

Effect of Intramedullar y Nail and Minimally Invasive Percutaneous Plate Internal Fixation on Clinical Indicators and Complications in Patients with Distal Tibial Fractures

目的以收集的胫骨远端骨折为研究对象,分别予以髓内钉和微创经皮钢板内固定进行治疗,比较两种治疗方案应用效果。方法收集2018年2月至2021年11月在本院就诊的胫骨远端骨折患者82例,依据患者的意愿进行分组,即将闭合复位髓内钉手术进行治疗的患者41例纳入至A组,将微创经皮钢板内固定治疗的患者41例纳入至B组。统计两组临床指标和并发症发生情况。结果两组手术时间、术中出血量、住院时间比较,P>0.05,B组术中透视次数显著低于A组,P<0.05。两组患者踝关节功能优良率比较,P>0.05。与A组比较,B组断钉、膝关节疼痛、骨折愈合延迟并发症发生率明显更低,B组感染方面并发症发生率明显更高,P<0.05。结论与闭合复位髓内钉手术比较,微创经皮钢板内固定术透视次数少,并发症发生率较低,但感染率高,且两种手术方案在改善踝关节功能方面效果具有一致性,临床上可根据患者意愿以及患者病情选取合适手术治疗。

Objective To take the collected distal tibial fractures as the research object,and respectively use intramedullary nails and minimally invasive percutaneous plate internal fixation for treatment,to compare the application effects of the two treatment schemes.Methods A total of 82 patients with distal tibial fracture admitted to our hospital from February 2018 to November 2021 were collected and divided into groups according to their wishes.41 patients undergoing closed reduction intramedullary nail surgery were included in group A,and 41 patients undergoing minimally invasive percutaneous plate internal fixation were included in group B.Clinical indicators and complications of the two groups were analyzed.Results The operation time,intraoperative blood loss and hospital stay of the two groups were compared,P>0.05.The intraoperative fluoroscopy times of group B were significantly lower than those of group A,P<0.05.Comparison of good and good rate of ankle joint function between 2 groups,P>0.05.Compared with group A,the incidence of complications of broken nails,knee pain and delayed fracture healing in group B was significantly lower,and the incidence of complications of infection in group B was significantly higher(P<0.05).Conclusions Compared with closed reduction intramedullary nail surgery,minimally invasive percutaneous plate internal fixation has fewer fluoroscopy times,lower complication rate,but higher infection rate,and the two surgical programs have the same effect in improving ankle joint function.Clinically,appropriate surgical treatment can be selected according to patients'wishes and patients'conditions.