旋入钉与交锁钉治疗胫骨骨折疗效的比较

目的 比较旋入式自锁髓内钉和交锁髓内钉在治疗胫骨骨折的临床疗效,以供临床参考.方法 对261例共266肢胫骨骨折进行手术治疗,采用交锁髓内钉固定160例162肢,旋入式自锁髓内钉固定101例104肢,对两组分别就其生物力学、手术操作、手术并发症、疗效以及手术适应证的各项指标进行比较分析.结果 对261例共266肢随访6个月以上,交锁钉组平均手术时间100 min,术中并发症12%,骨延迟愈合4.9%,骨折平均愈合时间18周,功能恢复优良率98.8%;旋入钉组平均手术时间45 min,术中并发症5%,骨延迟愈合1.9%,骨折平均愈合时间17周,功能恢复优良率99%.术后感染、畸形愈合方面两组大致相同,统计学无显著差异（P＞0.05）,治愈率均为100%.结论 两组疗效相同,感染率和骨畸形愈合率大致相同.旋入钉组手术操作简单、时间短、损伤小、术中并发症少、骨折愈合快,适合稳定性骨折,非缺损性粉碎性骨折.但抗旋转、短缩方面不及交锁钉,对非稳定性骨折、断端缺损性粉碎性骨折宜选择交锁钉.

Comparison between Self- locking Nail and Interloking Nail for the Therapeutic Effect of Tibial Fractures

Objective TO compare the therapeutie effeet of self- locking nail and interlocking nail on the treatment of tibial fractures, and provide reference for the clinical application. Methods Two hundred and sixty six tibial fractures in 261 patients were included. One hundred and sixty two fractures in 160 patients fixed with interlocking nails, and 104 fractres in 101 patients were by self- locking nail. The two groups were compared for their biomechanical stability, operative procedures, postperative complications, curative effect and indieateons. Results The patients were followed up for more than 6 months. In the interlocking group, the operation lasted averaged 100 minutes; the mean healing time was 18 weeks. There happened 12% complications and 4.9% delayed union. The excellent rat of function recovery was 98,8%. In the self- locking group, The mean operation time and healing time was 45 minutes and 17 weeks respectively. There happened 5 % complications and 1.9 % delayed union. The excellent rate was 99 % , There was no significant difference between two groups. Conclusion The operation with self- interlocking nail is easier and caused fewer injuries and complications, which should be applied to the stable fractures without defects. The interloking nail is adept to the unstable comminuted fractures with fractures with bone defects.