闭合复位带锁髓内钉及经皮微创锁定加压钢板治疗胫骨骨折的效果

Effect of Closed Reduction Interlocking Intramedullary Nail and Percutaneous Minimally Invasive Locking Compression Plate on Tibial Fracture

目的:观察闭合复位带锁髓内钉及经皮微创锁定加压钢板在胫骨骨折治疗中的应用效果。方法:选取十堰向氏骨科医院2020年1月─2021年8月接收的68例胫骨骨折患者。将其随机分为对照组和观察组,各34例。对照组采用闭合复位带锁髓内钉治疗,观察组采用经皮微创锁定加压钢板治疗。比较两组治疗效果、临床指标(术中出血量、手术时间、住院时间、骨折愈合时间)、并发症发生情况,比较两组术后3个月、6个月踝关节功能评分、膝关节功能评分。结果:观察组治疗优良率高于对照组,差异有统计学意义(P<0.05)。观察组术中出血量、手术时间、住院时间、骨折愈合时间均明显优于对照组,差异均有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。术后3个月、6个月,观察组踝关节功能评分、美国特种外科医院膝关节评分(HSS评分)均显著高于对照组,差异有统计学意义(P<0.05)。结论:经皮微创锁定加压钢板在胫骨骨折治疗中应用效果优于闭合复位带锁髓内钉,不仅可有效提高膝关节功能和踝关节功能,还有助于降低并发症发生率,缩短整体治疗时间。

Objective:To observe the effect of closed reduction interlocking intramedullary nail and percutaneous minimally invasive locking compression plate in the treatment of tibial fracture.Method:A total of 68 patients with tibial fracture admitted to Shiyan Xiangshi Orthopedic Hospital from January 2020 to August 2021 were selected.They were randomly divided into control group and observation group,34 cases in each group.The control group was treated with closed reduction interlocking intramedullary nail,and the observation group was treated with percutaneous minimally invasive locking compression plate.The therapeutic effect,clinical indicators(intraoperative blood loss,operation time,hospital stay,fracture healing time)and the incidence of complications were compared between the two groups.Ankle joint function score and knee joint function score were compared between the two groups 3 months and 6 months after surgery.Result:The rate of excellent and good treatment in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).The intraoperative blood loss,operation time,hospital stay and fracture healing time in the observation group were significantly better than those in the control group,the differences were statistically significant(P<0.05).The complication rate of observation group was lower than control group,the difference was statistically significant(P<0.05).At 3 months and 6 months after surgery,ankle joint function score and Hospital for Special Surgery knee score(HSS score)in the observation group were significantly higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion:The application effect of percutaneous minimally invasive locking compression plate in the treatment of tibial fractures is better than that of closed reduction locking intramedullary nailing,which can not only effectively improve the function of knee joint and ankle joint,but also help to reduce the incidence of complications and shorten the overall treatment time.