| 单髁置换术治疗膝关节自发性骨坏死的疗效分析 |
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Received:July 09, 2014
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| 作者 | Author | 单位 | Unit | E-Mail |
| 章年年 |
ZHANG Nian-nian |
绍兴市上虞人民医院骨科, 浙江 上虞 312300 |
Depaartment of Orthopaedics, Shangyu People's Hospital, Shangyu 312300, Zhejiang, China |
znn1149@163.com |
| 叶招明 |
YE Zhao-ming |
浙江大学医学院附属第二医院骨科, 浙江 杭州 310000 |
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| 任伟峰 |
REN Wei-feng |
绍兴市上虞人民医院骨科, 浙江 上虞 312300 |
Depaartment of Orthopaedics, Shangyu People's Hospital, Shangyu 312300, Zhejiang, China |
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| 朱仰义 |
ZHU Yang-yi |
绍兴市上虞人民医院骨科, 浙江 上虞 312300 |
Depaartment of Orthopaedics, Shangyu People's Hospital, Shangyu 312300, Zhejiang, China |
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| 期刊信息：《中国骨伤》2015年28卷，第4期，第363-367页 |
| DOI：10.3969/j.issn.1003-0034.2015.04.016 |
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目的:比较交锁髓内钉与钢板内固定微创治疗胫腓骨多段骨折的临床疗效。
方法:回顾性分析2010年1月至2013年6月收治的成人胫骨多段骨折患者39例,其中采用髓内钉治疗(髓内钉组)18例,男12例,女6例;年龄24～60岁,平均(40.6±9.7)岁;按AO分型,C2.1型7例,C2.2型11例。采用钢板固定治疗(钢板组)21例,男13例,女8例;年龄22～52岁,平均(41.7±8.1)岁;按AO分型,C2.1型7例,C2.2型13例,C2.3型1例。对两组患者术前准备时间、手术时间、术中出血量、术后并发症发生情况、骨折愈合时间进行分析,末次随访时采用Johner-Wruhs评价标准评价疗效。
结果:39例患者均获随访,时间10～28个月,平均15.2个月。交锁髓内钉组手术时间、术中出血量分别为(62.1±5.8) min、(70.9±7.1) ml,钢板组分别为(64.3±7.7) min、(74.1±8.5) ml,两组比较差异无统计学意义(P>0.05);交锁髓内钉组术前准备时间、骨折愈合时间分别为(5.3±0.7)d、(11.1±1.9)个月,钢板组分别为(7.1±0.8) d、(14.1±2.2)个月,两组比较差异有统计学意义(P<0.05).钢板组有5例发生术后并发症,末次随访时Johner-Wruhs评分,髓内钉组优11例,良4例,中3例;钢板组优11例,良5例,中3例,差2例。
结论:髓内钉微创治疗胫腓骨多段骨折较钢板内固定术前准备时间短、术后并发症少、术后骨折愈合快,但适用范围不如钢板,需严格掌握其适应证。 |
| [关键词]:胫骨骨折 骨折固定术,内 病例对照研究 |
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| Interlocking intramedullary nailling and micro-invasive internal fixation with plate for multiple segmental tibiofibular fractures:a case-control study |
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Abstract:
Objective:To compare the clinical effects of interlocking intramedullary nail and micro-invasive internal fixation with plate for the treatment of multiple segmental tibiofibular fractures.
Methods:The clinical data of 39 patients with multiple segmental tibiofibular fractures received treatment from January 2010 to June 2013 were retrospectively analyzed. In the 39 patients, 18 cases were treated by the interlocking intramedullary nail (intramedullary nail group), there were 12 males and 6 females with the mean age of (40.6±9.7) years old (ranged, 24 to 60 years);7 cases were type C2.1, 11 were type C2.2 according to the AO classification. The other 21 cases were treated by micro-invasive internal fixation with plate(plate group), there were 13 males and 8 females with the mean age of(41.7±8.1) years old(ranged, 22 to 52 years), 7 cases were type C2.1, 13 were type C2.2, 1 was type C2.3. Preoperative preparation time, operation time, intraoperative blood loss, postoperative complications, fracture healing time were compared between two groups. Johner-Wruhs evaluation criteria was used to evaluate the clinical effect at last follow-up.
Results:All the patients were followed up from 10 to 28 months with an average of 15.2 months. Operative time, intraoperative blood loss in intramedullary nail group were (62.1±5.8) min, (70.9±7.1) ml, respectively;in plate group were (64.3±7.7) min, (74.1±8.5) ml, respectively. There was no significant difference in operation time and intraoperative blood loss between two groups (P>0.05). However, preoperative preparation time, fracture healing time in intramedullary nail group were(5.3±0.7) days, (11.1±1.9) months, in plate group were (7.1±0.8) days, (14.1±2.2) months, respectively. No postoperative complications were found in intramedullary nail group, and five cases developed with complications in plate group. There was significant difference in preoperative preparation time, postoperative complications and fracture healing time between two groups(P<0.05). According to Johner-Wruhs criteria at last follow-up, 11 cases got excellent results, 4 good, 3 fair in intramedullary nail group;11 excellent, 5 good, 2 poor in plate group.
Conclusion:Interlocking intramedullary nail has advantages of shorter preoperative preparation time, less postoperative complications and faster fracture healing time in treating multiple segmental tibiofibular fractures. But the application scope of interlocking intramedullary nail was inferior to micro-invasive internal fixation with plate, and its indications should be strictly controlled. |
| KEYWORDS:Tibial fractures Fracture fixation,internal 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: | 章年年,叶招明,任伟峰,朱仰义.单髁置换术治疗膝关节自发性骨坏死的疗效分析[J].中国骨伤,2015,28(4):363~367 |
| 英文格式: | ZHANG Nian-nian,YE Zhao-ming,REN Wei-feng,ZHU Yang-yi.Interlocking intramedullary nailling and micro-invasive internal fixation with plate for multiple segmental tibiofibular fractures:a case-control study[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(4):363~367 |
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