胫骨交锁髓内钉治疗胫骨远端骨折临床疗效研究

目的探讨分析胫骨交锁髓内钉和经皮钢板内固定治疗胫骨远端骨折的临床疗效。方法回顾分析该院2010年1月—2012年9月采用交锁髓内钉或经皮钢板内固手术治疗的62例胫骨远端骨折患者的临床资料,根据手术方式分为髓内钉组(n=32)与钢板组(n=30),比较两组患者的一般资料及治疗效果。结果所有患者获得12月以上的随访,两组手术时间、踝关节最大背伸度、透视次数差异无统计学意义(P>0.05)。髓内钉组出血量少于钢板组(P<0.05)。所有患者均获得良好愈合,髓内钉组平均愈合时间为21.3周、钢板组为19.1周。髓内钉组有2例发生成角畸形愈合、钢板组有4例发生局部软组织并发症。结论交锁髓内钉和经皮钢板固定都是胫骨远端骨折的有效内固定方式,而交锁髓内钉对伴有局部软组织损伤的骨折更为有利。

Study on the Clinical Effects of Interlocking Intramedullary Nailing in Internal Fixation of Distal Tibia Fractures

Objective To compare the clinical effects between interlocking intramedullary nailing and percutaneous plating in internal fixation of distal tibia fractures. Methods The clinical data of 62 patients with distal tibia fractures admitted in our hospital from January, 2010 to September, 2012 were analyzed retrospectively. The patients were divided into intramedullary nailing group（n=32） and percutaneous plating group（n=30） according to different operation methods. The intramedullary nailing group was treated with intramedullary nail internal fixation and the percutaneous plating group was treated with percutaneous plate internal fixation. The general information and clinical effects were compared between the two groups. Results All the patients were followed up for more than 12 months. There were no statistically significant differences in operation time, the maximum ankle dorsinexion degree and X-ray exposure times between the two groups（P0.05）.The amount of bleeding of the interlocking intramedullary nailing group was less than that of the percutaneous plating group（P0.05）. All patients in both groups got well bony union. The mean union time was 20.3 weeks for the interlocking intramedullary nailing group and 19.1 weeks for the percutaneous plating group. 2cases in the interlocking intramedullary nailing group got angled malunion, and 4 cases in the percutaneous plating group had local soft tissue infections. Conclusion Both interlocking intramedullary nailing and percutaneous plating are well internal fixations for the distal tibia fractures, but the former is better for the treatment of fractures combined with local soft tissue injury.