胫骨干骨折治疗的临床研究

目的:对胫骨干骨折采用交锁髓内钉与动力加压接骨板治疗的疗效进行回顾性分析。方法:我院自2007年9月至2009年6月收入院的胫骨干骨折患者共45例,患者年龄17~67岁,平均(35.7±15.6)岁,其中男性31例,女性14例。闭合性骨折29例,开放性骨折15例,接骨板断裂转为髓内钉治疗1例。按长骨骨折AO分型:42A型15例,42B型24例,42C型6例。随访时间12~33个月。结果:交锁髓内钉治疗组16例,1例患者出现延迟愈合,13例患者平均骨折临床愈合时间约16周,疗效评估优良率81.3%,加压接骨板治疗组29例,3例患者出现延迟愈合,26例患者平均骨折临床愈合时间约15周,疗效评估优良率79.3%。结论:交锁髓内钉与动力加压接骨板在治疗胫骨干骨折时均为有效方法,但交锁髓内钉比动力加压接骨板在手术时间、出血量方面及术后感染、关节活动度等方面有优势,临床选择时需要综合评价各种因素予以应用。

Clinical research of tibial shaft fractures treatment

Objective: To retrospect the efficiency in tibial shaft fractures treated with Inter-locking intramedullary nail(IIN) and dynamic compression plate(DCP).Methods: In the retrospective study,all 45 patients with tibial fractures were registered between September 2007 and June 2009.Patients are aged 17 to 67,(35.7±15.6),and include 31 male and 14 female.29 cases are closed fractures,15 cases are open fractures,and 1 case is cleidocranialdyspasia plate fracture into intramedullary nailing treatment.According to the long bone fracture AO type: 15 cases are 42 A,24 cases are 42 B,6 cases are 42 C.Follow-up time 12-33 months.Results: IIN group(16),and one patient appears delayed union,15 patients average fracture clinical healing time about 16 weeks,efficacy rate 81.3%.DCP group(29),three patients appears delayed union,26 patients average fracture clinical healing time about 15 weeks,efficacy rate 79.3%.Conclusion: Efficiency might be no difference in DCP and IIN for patients with tibial shaft fracture in primary hospital in China,while patient can get more benefit in less operative exposure、 blood loss 、postoperative infection and joint activity.It needs to assess all kinds of factors synthetically in application.