| 胫骨干骨折带锁髓内钉固定和钢板螺钉固定的对比研究 |
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Received:October 30, 2007
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| 作者 | Author | 单位 | Unit | E-Mail |
| 黄鹏 |
HUANG Peng |
中国人民解放军总医院骨科，北京 100853 |
Department of Orthopaedics,PLA General Hospital,Beijing 100853,China |
harryhp@vip.sina.com |
| 唐佩福 |
TANG Pei-fu |
中国人民解放军总医院骨科，北京 100853 |
Department of Orthopaedics,PLA General Hospital,Beijing 100853,China |
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| 姚琦 |
YAO Qi |
中国人民解放军总医院骨科，北京 100853 |
Department of Orthopaedics,PLA General Hospital,Beijing 100853,China |
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| 梁雨田 |
LIANG Yu-tian |
中国人民解放军总医院骨科，北京 100853 |
Department of Orthopaedics,PLA General Hospital,Beijing 100853,China |
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| 陶笙 |
TAO Sheng |
中国人民解放军总医院骨科，北京 100853 |
Department of Orthopaedics,PLA General Hospital,Beijing 100853,China |
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| 张群 |
ZHANG Qun |
中国人民解放军总医院骨科，北京 100853 |
Department of Orthopaedics,PLA General Hospital,Beijing 100853,China |
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| 郭义柱 |
GUO Yi-zhu |
中国人民解放军总医院骨科，北京 100853 |
Department of Orthopaedics,PLA General Hospital,Beijing 100853,China |
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| 梁向党 |
LIANG Xiang-dang |
中国人民解放军总医院骨科，北京 100853 |
Department of Orthopaedics,PLA General Hospital,Beijing 100853,China |
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| 王岩 |
WANG Yan |
中国人民解放军总医院骨科，北京 100853 |
Department of Orthopaedics,PLA General Hospital,Beijing 100853,China |
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| 期刊信息：《中国骨伤》2008年21卷，第4期，第261-263页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的：对照回顾性分析带锁髓内钉和钢板内固定两种方法治疗胫骨干骨折的效果。
方法：髓内钉组32例(35处骨折),根据AO分型，42A型11处，42B型18处，42C型6处；钢板组42例(45处骨折),42A型10处，42B型22处，42C型13处。平均伤后手术时间在髓内钉和钢板组分别为3 d和3.5 d.随访评估患者手术时间，活动度，愈合时间，术后并发症之间的差别。
结果：术后平均随访13个月(8～26个月).髓内钉组平均手术时间为84 min,钢板螺钉组平均为93 min.髓内钉组踝关节平均背屈度为13°(0°～20°),钢板组为11°(0°～20°);跖屈分别为41°(30°～50°),47°(30°～50°).愈合时间髓内钉组平均为3.3个月，钢板螺钉平均为3.5个月。术后X线片显示髓内钉固定有1例出现旋转畸形，钢板组有3例出现成角畸形，均为胫骨远端1/3骨折。
结论： 在治疗胫骨骨折方面，带锁髓内钉和钢板内固定两种方法都可以取得理想的效果。 |
| [关键词]:胫骨骨折 骨折固定术，髓内 内固定器 临床对照试验 |
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| A comparisive study between intramedullary interlocking nail and plate-screw fixation in the treatment of tibial shaft fractures |
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Abstract:
Objective: To evaluate the effects of tibial shaft fractures treatment with plate-screw or intramedullary interlocking nail.
Methods: Thirty-five fractures were treated with intramedullary interlocking nail. Tape A,B and C were 11,18 and 6 cases respectively according to AO classification. Forty-five fractures were treated with plate-screw system. Type A,B and C were 10,22 and 13 cases respectively. The mean time between injury and operation was 3 days and 3.5 days respectively. The patients were evaluated with operation time,range of motion,time of bone union,and complications after a mean follow-up of 13 months(range 8 to 26 months).
Results: The mean operation time and the mean range of motion of the ankle and knee were found similar in both groups. The average dorsiflexion angle of ankle was 13°(0° to 20°)in locked intramedullary nailing group and 11°(0° to 20°)in plate group. The average plantar flextion angle of ankle was 41°(30° to 50°)in locked intramedullary nailing group and 47°(30° to 50°)in plate-screw group. The mean time of bone union was 3.3 months with intramedullary nailing and 3.5 months with plate-screw fixation. Length discrepancy occurred in only two patients (2 and 2.5 cm) with intramedullary interlocking nail. One patient treated by intramedullary interlocking nail for a type III open fracture occured osteomyelitis. Plain radiographs showed rotation in two patients with intramedullary interlocking nail and angulation in 3 patients with plate-screw fixation,which were distal-third tibial fractures.
Conclusion: Plate-screw osteosynthesis could attain satisfactory results in uncomminuted tibia shaft fractures,and locked intramedullary nailing is more appropriate in comminuted fractures. |
| KEYWORDS:Tibial fractures Fracture fixation,intramedullary Internal fixators Controlled clinical trials |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 黄鹏,唐佩福,姚琦,梁雨田,陶笙,张群,郭义柱,梁向党,王岩.胫骨干骨折带锁髓内钉固定和钢板螺钉固定的对比研究[J].中国骨伤,2008,21(4):261~263 |
| 英文格式: | HUANG Peng,TANG Pei-fu,YAO Qi,LIANG Yu-tian,TAO Sheng,ZHANG Qun,GUO Yi-zhu,LIANG Xiang-dang,WANG Yan.A comparisive study between intramedullary interlocking nail and plate-screw fixation in the treatment of tibial shaft fractures[J].zhongguo gu shang / China J Orthop Trauma ,2008,21(4):261~263 |
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