胫骨干骨折手术疗效分析

Analysis of Various Treatments of Tibial Shaft Fracture

目的 探讨适合胫骨干骨折的手术治疗方法及并发症的预防措施。方法 回顾性分析手术治疗胫骨干骨折病例67例,根据选择手术方式不同,将病例分为交锁髓内钉、加压钢板和外固定支架3组,临床观察结合X线片评价骨折愈合、延迟愈合、不愈合作为判断临床疗效标准。结果 髓内钉组的骨折愈合率明显高于加压钢板和外固定支架组,外固定组的骨折延迟愈合率高于其他两组;并发症包括骨不连、关节僵硬及畸形愈合,发生率为22.4％,其中骨不连发生率为13.4％。结论 髓内钉内固定治疗胫骨干骨折的临床疗效优于加压钢板和外固定支架;骨不连为胫骨骨折常见并发症,应严格掌握适应证、规范手术操作。

Objective To explore the proper method for the treatment of tibial shaft fracture and the prevention against complications after surgery. Methods The data of 67 cases of tibial shaft fractures were collected and analyzed retrospectively. The cases were devided into three groups according to the various treatments which included interlocking intramedullary nail group, dynamic compression plate group and external fixation frame group. The therapeutic effect was judged by X-ray examination and clinical observation to determine whether occurred union, delayed union or non-union of the fracture, Results The fracture union rate in intramedullary nail group was higher than that in dynamic compression plate group and external fixation frame group. And the fracture delayed union rate in external fixation frame group was higher than that in the other two groups. Complications included non-union, ankylosis of the joint and malunion. The occurred rate of complications was 22.4% , while the non-union rate was 13. 4% . Conclusion The Clinical results of intramedullary nail for the tibial shaft fractures is better than dynamic compression plate and external fixation frame. Non-union is the most frequent complication of the tibial shaft fractures, and we should master the indications strictly and normalize the procedure of the surgery.