交锁髓内钉复合固定治疗胫腓骨骨折

Clinical Treatment of Middle-lower Fractures of Tibia-Fibula with Compound Fixation

目的 探讨采用胫骨交锁髓内钉加腓骨钢板复合固定治疗胫腓骨中下段双骨折临床疗效。 方法 1999年 7月～ 2 0 0 1年 7月 ,共有 2 6例胫腓骨中下段双骨折采用交锁髓内钉和腓骨钢板固定治疗 ;男 2 0例 ,女 6例 ,平均年龄 35岁 (18岁～ 6 0岁 ) ,其中闭合骨折 16例 ,开放骨折 10例。先复位固定腓骨骨折 ,采用适宜的钢板固定 ,再行胫骨复位交锁髓内钉固定。 结果 2 6例术后均获得随访 ,平均随访时间 8个月 (6～ 16个月 )。最终结果评定采用Johner-Wruh评分标准 :优 18例 ,良 4例 ,中 2例 ,差 2例。在 16例闭合骨折中 ,骨折平均愈合时间为 14周 (11～ 17周 )。最终评定结果 ;优 12例 ,良 2例 ,中 2例。 10例开放性骨折均为新鲜骨折 ,骨折平均愈合时间为 18周 (14～ 2 0周 )。最终评定结果 :优 6例 ,良 3例 ,差 1例。 结论 胫腓骨中下段双骨折采用交锁髓内钉复合固定在临床上是一种固定可靠、安全、有利早期活动。

Objective To investigate the clinical effect of fractures of the tibia-fibula with tibia interlocking intramedullary nail and fibula plate.Methods 26 patients had been treated with tibia interlocking intramedullary nail and fibula plate from July 1999 to July 2001.Male 20 patients,female 6 patients,average 35 years old(18～60 years old).Among them there were 16 close fracure patients,open fracture 10 patients.First fibula fractures were reduced and fibula plate were applied with internal fixation.Next tibia fractures were reduced and tibia interlocking intramedullary nail were applied with internal fixation. Results Follow-up studies were obtained in all 26 patients average 8 months(6～16 months).According to Johner-Wruh standard:excellent in 18 patients,good in 4 patients,fair in 2 patients and poor in 2 patients.In 16 patients with close fracture average healing time was 14 weeks(11～17 weeks).Evaluation result:excellent in 12 patients,good in 2 patients,fair in 2 patients.In 10 patients with open frature average healing time was 18 weeks(14～20 weeks),Evaluation result:excellent in 6 patients,good in 3 patients and poor in 1 patient.Conclusion To middle-lower fractures of the tibia-fibula,the compound fixaton of tibia interlocking intramedullary nail and fibula plate is one method of fixation stable,safety,benefit to earlier exercise and promoting fracture healing. KEY WORDS interlocking intramedullary,tibia fracture,fibula fracture,internal fixation Analysis of Relationship between Treadmill Exercise Test and Coronary Angiography Li Muwei; Gao Chuanyu;Huang Kejun;et al. Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou 450003,China ABSTRACT Objective To explore the relationship between electrocardiogram exercise test and coronary angiography.Methods 116 patients with coronary heart disease(CHD) and suspected CHD underwent electrocardiogram exercise test and coronary angiography. Their results were analyzed.Results The sensitivity specificity and accuracy rate in diagnosis of CHD with electrocardiogram exercise test were 80%(60/75) ,80 9(8/41) and 69 8%(23/116). It is related to degree of ST depression occurring time of ST depression duration of ST with coronary artery stenosis extent in depression electrocardiogram exercise test. Conclusion The electrocardiogram exercise test is a valuable means to diagnose CHD and to evaluating coronary artery stenosis extent.