交锁髓内钉合侧方钢板内固定与可桥接钢板内固定治疗下肢骨干无菌性骨不连的临床效果对比研究

目的 比较交锁髓内钉合侧方钢板内固定治疗与可桥接钢板内固定治疗下肢骨干无菌性骨不连的临床效果.方法 随机选取2011年10月～2013年11月在本院骨科手术治疗下肢骨干无菌性骨不连手术的256例患者为研究对象,根据治疗方法不同分成两组,交锁髓内钉组142例采用交锁髓内钉合侧方钢板内固定治疗,可桥接钢板组114例采用可桥接钢板内固定治疗,对比两组的围术期及术后随访情况.结果 术后256例患者骨折愈合且无并发症.交锁髓内钉组出血量和引流血量多于可桥接钢板组,内固定时间、临床愈合时间、影像愈合时间、住院时间长于可桥接钢板组,手术时间短于可桥接钢板组,骨痂评分低于可桥接钢板组,住院费用高于可桥接钢板组,差异均有统计学意义（P＜0.05）.结论 两种下肢骨干骨不连的临床治疗方法均取得较好疗效,临床医生可根据患者的既往创伤程度、经济水平以及医院现有技术等综合考虑,选择最有利的治疗方式.

Clinical efficacy comparison and study on intramedullary nail fixation and bridging plate fixation in the treatment of lower limb shaft aseptic nonunion

Objective To compare the clinical effects of interlocking intramedullary nailing fixation and bridging plate fixation in the treatment of lower limb shaft aseptic nonunion. Methods 256 patients with lower limb shaft aseptic nonunion treated by orthopedic surgery in our hospital from October 2011 to November 2013 were selected randomly and divided into intramedullary nailing group with 142 cases and bridge plate group with 114 cases according to different treatment.Perioperative and postoperative follow-up case of two groups were compared. Results After surgery, 256 patients with fracture healing and had no complications.The amount of bleeding and drainage volume in intramedullary nailing group was more than that in bridge plate group respectively,within the fixed time,clinical healing time,image healing time,hospital stay time in intramedullary nailing group was longer than that in bridge plate group respectively,surgical time in intramedullary nailing group was shorter than that in bridge plate group,callus score in intramedullary nailing group was lower than that in bridge plate group,hospital cost in intramedullary nailing group was higher than that in bridge plate group,with statistical difference（P〈0.05）. Conclusion Two methods of backbone of lower limb bone nonunion has good effect,according to the extent of the patient＇s traumatic past,economic level and the hos- pital＇s existing technology, clinicians can select the best way of treatment.