胫骨专家型髓内钉固定与微创锁定加压钢板固定对胫骨远端骨折愈合临床疗效的对比分析

目的对比探究胫骨专家型髓内钉固定和微创锁定加压钢板固定治疗胫骨远端骨折后愈合的情况。方法选取2011年1月~2015年1月在我院治疗的胫骨远端骨折患者90例,分为胫骨专家型髓内钉固定组(n=45)与微创锁定加压钢板固定组(n=45),术后随访时间为12~24个月,平均18个月。观察两组患者手术时间,术中出血量,手术前后住院天数、骨折愈合时间、术后并发症发生率。结果胫骨专家型髓内钉固定组与微创锁定加压钢板固定组的平均手术时间分别为(68.41±13.74)min、(86.79±15.56)min,术中平均出血量分别为(108.1±12.7)mL,(159.5±27.9)mL;住院时间分别为(18.14±2.57)天、(22.28±2.35)天(P0.05);骨折愈合时间为(20.15±2.47)周、(24.02±3.31)周,术后并发症发生率分别为6.7%(3/45),26.7%(12/45)(P0.05)。结论胫骨专家型髓内钉与微创锁定加压钢板治疗胫骨远端骨折相比,胫骨专家型髓内钉在治疗胫骨远端骨折方面具有显著优势。

To compare the clinical effect of interlocking intramedullary nail fixation and minimally invasive locking plate fixation in the treatment of fracture healing

Objective To analyze the clinical effect of interlocking intramedullary nail and minimally invasive locking plate fixation in the treatment of distal tibial fractures. Methods 90 cases of distal tibial fractures treated in our hospital from Jan 2011 to Jan 2015 were selected in this study. The subjects were divided into two groups: interlocking intramedullary nail fixation group (n=45) and minimally invasive locking plate fixation group (n=45). The Follow-up time of the patients was 12-24 months, average 18 months. The operative time, intraoperative blood loss, length of hospital stay, time of fracture healing, and postoperative complications were observed in the two groups. Results The average operation time of the interlocking intramedullary nail fixation group were (68.4±13.7) min. The average operation time of the plate fixation group were (77.7±15.6) min. The average amount of bleeding was (108.1±12.7) mL, (159.5±27.9) mL respectively. The time of hospital-stay were (22.9±7.4) days, (30.8±4.5) days respectively (P<0.05). The fracture healing time was (77.1±5.4) days, (91.6±7.1) days respectively. The incidence of postoperative complications was 6.7% (3/45), 26.7% (12/45) respectively (P<0.05). Conclusion Compared with the treatment of distal tibial fractures with interlocking intramedullary nail and steel plate, interlocking intramedullary nail has a significant advantage in the treatment of distal tibial fractures.