带锁髓内钉与钢板在治疗胫骨开放骨折中的对比研究

目的:通过与传统钢板内固定对比,研究和探讨带锁髓内钉在治疗胫骨开放骨折中的价值。方法:收集胫骨开放骨折带锁髓内钉治疗患者32例为研究组,其中男20例,女12例,年龄18~61岁,左侧22例,右侧10例,合并腓骨骨折30例。骨折部位上段8例,中段15例,下段9例;收集胫骨开放骨折钢板内固定治疗患者50例为对照组,其中男32例,女18例,年龄17~62岁,左侧37例,右侧13例,合并腓骨骨折42例,骨折部位上段13例,中段22例,下段15例。结果:研究组32例,随诊28例,Johner-w ruh评分:优24例,良3例,差1例。对照组50例全部随诊,Johner-w ruh评分优21例,良18例,差11例,经χ2检验研究组优的比例高于对照组,差异有统计学意义。差的比例低于对照组,差异有统计学意义。结论:应用带锁髓内钉治疗开放性胫骨骨折是目前比较好的手术选择。

Comparative study of interlocking intramedullary nail fixation and plate fixation in tibial open fracture treatment

Objective:By comparison with plate fixation,to evaluate the value of interlocking intramedullary nail fixation in tibial open fracture treatment.Methods:Thirty-two patients with tibial fracture treated with interlocking intramedullary nail were study group.There is 20 male and 12 female with mean age 38.6 years(range 18～61 years).Left in 22 cases and right in 10 cases,30 cases combined fibular fracture.8 cases located at proximal tibia,15 cases at middle and 9 cases at distal tibia.Control group were 50 patients with tibial fracture treated with plate fixation,in which left in 37 cases and right in 13 cases,42 cases combined fibular fracture.13 cases located at proximal tibia,22 at middle and 15 cases at distal tibia.Results:Among all of 32 cases of study group,28 cases were followed up,Johner-wruh score showed good in 24 cases,better 3 cases and poor in 1 case.All of the control group were followed up,Johner-wruh score showed good in 21 cases,better 18 cases and poor in 11 cases.χ~2-test proved that the ratio of good in study group were higher than control group and two methods had significant difference(P<0.05).Conclusion:Interlocking intramedullary nail fixation is one of the good alternatives in treating tibial open fracture.