| 髓内钉治疗胫腓骨中下1/3骨折腓骨固定与否的疗效比较 |
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投稿时间：2019-05-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 单涛 |
SHAN Tao |
安徽医科大学第三附属医院创伤骨科, 安徽 合肥 230001 |
Department of Traumatic Orthopaedics, the Third Affiliated Hospital of Anhui Medical University, Hefei 230001, Anhui, China |
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| 宁仁德 |
NING Ren-de |
安徽医科大学第三附属医院创伤骨科, 安徽 合肥 230001 |
Department of Traumatic Orthopaedics, the Third Affiliated Hospital of Anhui Medical University, Hefei 230001, Anhui, China |
nrd192@qq.com |
| 周业金 |
ZHOU Ye-jin |
安徽医科大学第三附属医院创伤骨科, 安徽 合肥 230001 |
Department of Traumatic Orthopaedics, the Third Affiliated Hospital of Anhui Medical University, Hefei 230001, Anhui, China |
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| 方闰 |
FANG Run |
安徽医科大学第三附属医院创伤骨科, 安徽 合肥 230001 |
Department of Traumatic Orthopaedics, the Third Affiliated Hospital of Anhui Medical University, Hefei 230001, Anhui, China |
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| 赵禹 |
ZHAO Yu |
安徽医科大学第三附属医院创伤骨科, 安徽 合肥 230001 |
Department of Traumatic Orthopaedics, the Third Affiliated Hospital of Anhui Medical University, Hefei 230001, Anhui, China |
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| 倪志豪 |
NI Zhi-hao |
安徽医科大学第三附属医院创伤骨科, 安徽 合肥 230001 |
Department of Traumatic Orthopaedics, the Third Affiliated Hospital of Anhui Medical University, Hefei 230001, Anhui, China |
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| 期刊信息：《中国骨伤》2020年，第33卷，第1期，第27-38页 |
| DOI：10.3969/j.issn.1003-0034.2020.01.005 |
| 基金项目: |
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中文摘要:
目的：分析比较腓骨钢板固定与否对髓内钉治疗胫腓骨中下1/3骨折的疗效。
方法：回顾分析2016年7月至2018年9月胫骨采用髓内钉内固定、腓骨采用钢板固定或不固定的65例胫腓骨中下1/3骨折患者，其中男46例，女19例，年龄22～61岁。腓骨固定组37例，男27例，女10例；腓骨未固定组28例，男19例，女9例。通过比较两组手术时间、术中出血量、骨折愈合时间、踝关节旋转及外翻角度、术后并发症、末次随访踝关节活动度及Baird-Jackson评分来评定手术疗效。
结果：所有患者获得随访，时间12～16（13.67±1.23）个月。共出现3例腓侧切口感染，切口均Ⅰ期愈合，无切口裂开；共出现4例骨折延迟愈合，无不愈合现象。腓骨固定组踝关节外旋增大（7.16±1.36）°，外翻角（3.35±1.16）°；未固定组外旋增大（10.25±1.58）°，外翻角（6.46±1.23）°，差异有统计学意义（P<0.05）。两组踝关节活动度、骨折愈合时间及并发症发生率差异无统计学意义（P>0.05）；手术时间、术中出血量及末次随访Baird-Jackson评分差异有统计学意义（P<0.05）。
结论：对于胫骨采用髓内钉固定的胫腓骨中下1/3骨折，腓骨钢板固定能够阻止踝关节外旋不良及外翻畸形，可以获得更好的手术效果及功能预后。 |
| 【关键词】胫骨骨折 腓骨 骨折固定术,髓内 骨折固定术,内 |
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| Curative effect comparison for fixation of fibula or not for the treatment of middle and lower 1/3 fractures of tibia and fibula with intramedullary nail |
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ABSTRACT
Objective: To analyze and compare the effect of fibular plate fixation on the treatment of tibial and fibular fractures.
Methods: From July 2016 to September 2018,65 cases of middle and lower 1/3 fractures of tibia and fibula were retrospectively analyzed,including 46 males and 19 females,aged 22 to 61 years old. There were 37 cases in fibular fixation group (27 males and 10 females),28 cases in fibular non fixation group (19 males and 9 females). By comparing the operation time,intraoperative bleeding,fracture healing time,ankle rotation and valgus angle,postoperative complications,last follow-up ankle mobility and Baird Jackson score,the operation effect was evaluated.
Results: All patients were followed up for 12 to 16 months with an average of(13.67±1.23) months. There were 3 cases of infection of the fibular incision,all of which healed in the first stage without incision dehiscence,and 4 cases of delayed union without nonunion. In the fibula fixation group,the external rotation of ankle joint increased (7.16±1.36)° and the valgus angle increased (3.35±1.16)°;while in the non fixation group,the external rotation increased (10.25±1.58)° and the valgus angle increased (6.46±1.23)° with statistical significance(P<0.05). There was no significant difference in ankle joint activity,fracture healing time and complication rate between two groups(P>0.05);there was significant difference in operation time,intraoperative hemorrhage and Baird Jackson score at the latest follow-up(P<0.05).
Conclusion: The fibular plate fixation can prevent the ankle joint from malrotation and valgus deformity,and can obtain better surgical effect and functional prognosis. |
| KEY WORDS Tibial fractures Fibula Fracture fixation,intramedullary Fracture fixation,internal Giorgio Calori2013 |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 单涛,宁仁德,周业金,方闰,赵禹,倪志豪.髓内钉治疗胫腓骨中下1/3骨折腓骨固定与否的疗效比较[J].中国骨伤,2020,33(1):27~38 |
| 英文格式: | SHAN Tao,NING Ren-de,ZHOU Ye-jin,FANG Run,ZHAO Yu,NI Zhi-hao.Curative effect comparison for fixation of fibula or not for the treatment of middle and lower 1/3 fractures of tibia and fibula with intramedullary nail[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(1):27~38 |
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