不同治疗方式治疗胫骨干骨折的疗效比较

Efficacy comparison of percutaneous minimally invasive reduction bridging combined internal fixation system and intramedullary nail fixation in the treatment of tibial shaft fractures

目的探讨经皮微创复位桥接组合式内固定系统(BCFS)与髓内钉固定治疗胫骨干骨折的效果。方法将我院收治的胫骨干骨折患者56例,随机分为对照组和观察组,每组28例。对照组采用髓内钉内固定治疗,观察组采用经皮微创复位BCFS治疗。比较两组的手术相关指标、膝关节评分(HSS)与踝关节评分(AOFAS)、临床疗效和并发症发生情况。结果观察组术中出血量、负重时间少于对照组(P<0.05);两组术后6个月HSS和AOFAS评分均较术前增加(P<0.05);两组手术时间、术后住院时间和骨折愈合时间比较,P>0.05;两组术后6个月HSS、AOFAS评分,临床疗效和并发症情况比较,P>0.05。结论经皮微创复位BCFS和髓内钉固定均是胫骨干骨折的有效术式,二者对骨折愈合及关节功能的恢复效果相当,安全性均较高,但经皮微创复位BCFS在减少手术创伤和实现早期康复锻炼上更有优势。

Objective To explore the efficacy of percutaneous minimally invasive reduction bridging combined internal fixation system(Bridge combined fixation system,BCFS)and intramedullary nail fixation in the treatment of tibial shaft fractures.Methods Fifty six tibial shaft fracture patients treated in the Department of orthopedic surgery of our hospital were randomly divided into the control group and the observation group,with 28 cases in each group.The control group was treated with intramedullary fixation,and the observation group was treated with percutaneous minimally invasive reduction of BCFS.Surgery related indicators,hospital for special surgery(HSS)score,American orthopedic foot and ankle society(AOFAS)score,efficacy,and complications were compared between the two groups.Results Intraoperative blood loss and weight-bearing time in the observation group were less than those in the control group(P<0.05).The HSS and AOFAS scores increased in the two groups 6 months after operation(P<0.05).There were no significant difference in operation time,hospitalizationtime,and fracture healing time between the two groups(P>0.05).6 months after operation,there were no significant difference in HSS and AOFAS scores,efficacy and complication rates between the two groups(P>0.05).Conclusion Percutaneous minimally invasive reduction BCFS and intramedullary nail fixation are both effective surgical methods for tibial shaft fractures,and they have comparable efficacy and safety in terms of fracture healing and joint function recovery,but percutaneous minimally invasive reduction BCFs is more advantageous in reducing surgical trauma and accelerating the recovery of weight-bearing ability.