微创锁定钢板和交锁髓内钉治疗胫腓骨骨折的疗效分析

目的分析比较2种内固定治疗胫腓骨骨折的临床疗效及术后并发症。方法选择2008年6月-2011年6月收治的资料完整、均获得随访的102例胫腓骨骨折患者，根据手术方式不同，将患者分为微创钢板内固定组50例、交锁髓内钉内固定组52例。记录两组手术时间、出血量、术后并发症、下地时间、骨折愈合时间以及植入后1年膝关节HSS评分结果。结果102例患者均获随访，随访时间13-18个月。微型锁定钢板内固定组手术时间、出血量均低于交锁髓内钉内固定组（P〈0．05）。随访50例微型钢板患者2例感染，1例延迟愈合，1例畸形愈合，无不愈合发生；52例交锁髓内钉内固定组1例感染，1例延迟愈合，1例不愈合，无畸形愈合发生。结论两组术后并发症发病率、下地时间、置人后1年膝关节HSS评分及生物相容性差异无统计学意义，提示采用微创锁定钢板治疗胫骨骨骨折较交锁髓内针更为微创，具有手术时间短优势。

Comparsion of the therapeutic effects of less invasive locking plate and interlocking intramedullary nail for tibial and fibula shaft fractures

Objective To investigate and discuss the clinical outcomes and complications of two kinds of internal fixation in the treatment of the tibial and fibula shaft fractures.Methods A retrospective study was carried out in 102 patients from June 2008 to June 2011 which was suffer the tibia and fibula shaft fractures.According to different surgery ways,the patients were divided into 50 cases of less invasive locking plate group and 52 cases of interlocking intramedullary nail group.Operation time and intra-operative blood loss,postoperative complications,time of leaving bed,time of bone union,and the HSS score of the knee were recorded.Results All the 102 patients were followed for 13-18 months.The time of operation and intra-operative blood loss in less invasive locking plate group were lower than those in interlocking intramedullary nail group(P < 0.05).2 patients got infection,1 patient was delayed union,1 patient was malunion,no nonunion in less invasive locking plate group;1 patient was infection,1 patient was delayed union,1 patient was nonunion,no nonunion in interlocking intramedullary nail group.Conclusion There were no statistical differences in postoperative complications,the time of bone union,and the HSS score of the knee in the two group,which shows that less invasive locking plate versus interlocking intramedullary nail has the advantage of more minimal and less time of operation.