| 不同固定方法治疗96例胫骨骨折的病例对照研究 |
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Received:December 08, 2011
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| 作者 | Author | 单位 | Unit | E-Mail |
| 张洪 |
ZHANG Hong |
桐乡市第二人民医院骨科, 浙江 桐乡 314511 |
Department of Orthopaedics, the Second People's Hospital of Tongxiang, Tongxiang 314511, Zhejiang, China |
jiang_shumin@126.com |
| 叶茶花 |
YE Cha-hua |
九江学院理学院 |
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| 于虎 |
YU Hu |
桐乡市第二人民医院骨科, 浙江 桐乡 314511 |
Department of Orthopaedics, the Second People's Hospital of Tongxiang, Tongxiang 314511, Zhejiang, China |
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| 杨徐松 |
YANG Xu-song |
桐乡市第二人民医院骨科, 浙江 桐乡 314511 |
Department of Orthopaedics, the Second People's Hospital of Tongxiang, Tongxiang 314511, Zhejiang, China |
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| 期刊信息：《中国骨伤》2012年25卷，第3期，第198-201页 |
| DOI：10.3969/j.issn.1003-0034.2012.03.005 |
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目的:比较应用有限切开锁定钢板内固定术、交锁髓内钉内固定术和外固定支架固定术3种手术方法治疗胫骨骨折的临床疗效。
方法:自2007年5月至2011年5月,分别采用有限切开锁定钢板内固定术、交锁髓内钉内固定术和外固定支架固定术3种手术方法治疗胫骨骨折96例。分为3组:锁定钢板内固定(A组)36例,男24例,女12例;交锁髓内钉内固定(B组)38例,男22例,女16例; 外固定支架固定(C组)22例,男12例,女10例。观察3组手术时间、骨折愈合时间、下地负重时间、并发症4项指标。术后下肢功能恢复情况按照Johner-Wruhs关节功能标准评定。
结果:96例均获随访,时间3～30个月,平均13个月。锁定钢板组手术时间(85.0±12.2) min,骨折愈合时间(143.0±12.3) d,下地负重时间(114.3±12.2) d,3例术后发生并发症,根据Johner-Wruhs评定优21例,良12例,中2例,差1例;交锁髓内钉组手术时间(90.0±14.6) min,骨折愈合时间(132.0±14.6) d,下地负重时间(46.0±12.2) d,3例术后发生并发症,根据Johner-Wruhs评定优24例,良11例,中2例,差1例;外固定支架固定组手术时间(70.0±10.2) min,骨折愈合时间(121.0±13.5) d,下地负重时间(108.2±8.9) d,2例术后发生并发症,根据Johner-Wruhs评定优16例,良5例,中0例,差1例。3组在手术时间、骨折愈合时间,并发症及术后下肢功能恢复方面差异无统计学意义,下地负重时间交锁髓内钉固定组优于锁定钢板固定和外固定支架固定组。
结论:3种固定方法有其各自特点,采用有限切开或闭合复位加固定治疗胫骨骨折是理想的治疗方法。 |
| [关键词]:胫骨骨折 骨折固定术 外固定器 病例对照研究 |
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| Case-control study on different fixation methods for the treatment of tibial fractures in 96 patients |
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Abstract:
Objective:To compare the therapeutic effects of limited excision and locking plate fixation,interlocking intramedullary nailing and external fixation in treating tibial fractures.
Methods:From May 2007 to May 2011,96 patients with tibial fractures were divided into three groups(Group A,Group B and Group C) and were treated with three kind of fixations including limited excision and locking plate fixation(36 cases in Group A,including 24 males and 12 females),interlocking intramedullary nailing(38 cases in Group B,including 22 males and 16 females) and external fixation(22 cases in Group C,including 12 males and 10 females). Operative time,healing time,weight-bearing time and complications were observed. Johner-Wruhs scoring was used to evaluate the function of lower limbs.
Results:All patients were followed up from 3 months to 30 months with an average of 13 months. In Group A,the operative time was(85.0±12.2) minutes;the healing time was(143.0±12.3) days;the weight-bearing time was(114.3±12.2) days;Complications occured in 3 patients. According to Johner-Wruhs scoring,the results were rated as excellent in 21 cases,good in 12 cases,moderate in 2 cases,and poor in 1 case;In Group B,the operative time was(90.0±14.6) minutes;the healing time was(132.0±14.6) days;the weight-bearing time was(46.0±12.2) days;Three patients occurred complications. According to Johner-Wruhs scoring,the results were rated as excellent in 24 cases,good in 11 cases,moderate in 2 cases,and poor in 1 case. In Group C,the operative time was(70.0±10.2) minutes;the healing time was(121.0±13.5) days;the weight-bearing time was(108.2±8.9) days;Two patients underwent complications. According to Johner-Wruhs scoring,the results were rated as excellent in 16 cases,good in 5 cases,moderate in 0 case,and poor in 1 case. There were no significant significance among three groups in operative time,healing time,complications and the lower limbs function recovered(P>0.05). But weight-bearing time in interlocking intramedullary nailing was better than in limited excision and locking plate fixation and external fixation(P<0.05).
Conclusion:Different fixation methods have different advantages. Limited excision,closed reduction with locking plate fixation is an ideal method to treat the tibial fracture. |
| KEYWORDS:Tibial fractures Fracture fixation External fixators Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 张洪,叶茶花,于虎,杨徐松.不同固定方法治疗96例胫骨骨折的病例对照研究[J].中国骨伤,2012,25(3):198~201 |
| 英文格式: | ZHANG Hong,YE Cha-hua,YU Hu,YANG Xu-song.Case-control study on different fixation methods for the treatment of tibial fractures in 96 patients[J].zhongguo gu shang / China J Orthop Trauma ,2012,25(3):198~201 |
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