胫腓骨远端关节外骨折钢板固定与髓内钉固定疗效比较

目的：比较钢板与髓内钉在胫腓骨远端关外骨折治中的疗效。方法：将我院骨科收住的胫腓骨远端关外骨折患者40例,随机分为治疗组20例与对照组20例,其中治疗组胫骨行髓内钉固定、腓骨行钢板固定；对照组胫骨与腓骨均采用钢板固定,比较两组患者在平均手术时间、术中平均出血量、术后1年踝关节功能,采用美国足踝矫形外科协会的踝部损伤量表(AOFAS)评定、骨折愈合时间、术后并发症五个方面的差异。结果：治疗组与对照组在平均手术时间、术中平均出血量、术后1年踝关节功能、骨折愈合时间四个方面两组患者比较无明显差异(P＞0.05)；但术后并发症治疗组明显优于对照组,差异有统计学意义(P＜0.05)。结论：胫腓骨远端骨折骨折多由高能量所致,多伴局部软组织损伤,因此,髓内钉固定相比钢板固定因其对软组织损伤更小,术后并发症少,在临床治疗中优势明显。

Comparison of Plate fixation and intramedullary nail fixation For distal tibia and fibula out of joint fractures

Objective: To compare the efficacy of plate and intramedullary nail in the treatment of distal tibia and fibula out of joint fractures. Methods: 40 cases of distal tibia and fibula fractures received in Department of orthopedics of our hospital were randomly divided into 20 cases in the treatment group and 20 cases in the control group. The treatment group was fixed with the tibial intramedullary nail and the fibula plate, and the control group was fixed with the plate of the tibia and fibula. The average operation time and the average bleeding amount in the two groups were compared. 1 years after the operation of ankle joint function, the United States ankle Orthopedic Association of ankle injury scale (AOFAS) assessment, fracture healing time, postoperative complications in five aspects of the difference. Results: There was no significant difference between the two groups in the treatment group and the control group in the two groups (P > 0.05) in the average operation time, the average amount of bleeding, the ankle joint function and the healing time of the fracture (P > 0.05), but the postoperative complication treatment group was significantly better than the control group (P < 0.05). Conclusion: The fractures of the distal tibia and fibula are mostly caused by high energy and many local soft tissue injuries. Therefore, the intramedullary nail fixation is less than the steel plate fixation because of its less injury to the soft tissue, and the postoperative complications are less, and the advantages are obvious in the clinical treatment.