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微创弹性髓内钉和钢板内固定治疗成人胫腓骨骨折的病例对照研究
Hits: 429   Download times: 175   Received:July 25, 2023    
作者Author单位UnitE-Mail
祝海炳 ZHU Hai-bing 浙江省舟山市中医院骨科, 浙江 舟山 316000 Department of Orthopaedics Zhoushan Hospital of Traditional Chinese Medicine, Zhoushan 316000, Zhejiang, China 554255081@qq.com 
张永涛 ZHANG Yong-tao 浙江省舟山市中医院骨科, 浙江 舟山 316000 Department of Orthopaedics Zhoushan Hospital of Traditional Chinese Medicine, Zhoushan 316000, Zhejiang, China  
吕和 LYU He 浙江省舟山市中医院骨科, 浙江 舟山 316000 Department of Orthopaedics Zhoushan Hospital of Traditional Chinese Medicine, Zhoushan 316000, Zhejiang, China  
任富昌 REN Fu-chang 浙江省舟山市中医院骨科, 浙江 舟山 316000 Department of Orthopaedics Zhoushan Hospital of Traditional Chinese Medicine, Zhoushan 316000, Zhejiang, China  
周成洪 ZHOU Cheng-hong 浙江省舟山市中医院骨科, 浙江 舟山 316000 Department of Orthopaedics Zhoushan Hospital of Traditional Chinese Medicine, Zhoushan 316000, Zhejiang, China  
应昀峰 YING Yun-feng 浙江省舟山市中医院骨科, 浙江 舟山 316000 Department of Orthopaedics Zhoushan Hospital of Traditional Chinese Medicine, Zhoushan 316000, Zhejiang, China  
期刊信息:《中国骨伤》2024年37卷,第4期,第352-357页
DOI:10.12200/j.issn.1003-0034.20230167
基金项目:浙江省中医药科技计划(编号:2022ZB381)


目的: 对比使用弹性髓内钉和钢板固定胫腓骨骨折的临床疗效。

方法: 选取2015年1月至2022年12月入院的60例胫腓骨骨折患者,分为髓内钉组和钢板组,各30例,髓内钉组为采用弹性髓内钉固定,钢板组为钢板螺钉固定。髓内钉组男18例,女12例;年龄22~75(39.4±9.8)岁;车祸伤24例,摔伤6例;闭合性骨折23例,开放性骨折7例。钢板组30例,男15例,女15例;年龄24~78(38.6±10.2)岁;车祸伤22例,摔伤8例;闭合性骨折24例,开放性骨折6例。比较两组的手术时间、术中出血量、美国足踝外科协会(American Orthopedic Foot and Ankle Society,AOFAS)踝和后足评分、腓骨临床愈合时间和伤口并发症的发生率等情况。

结果: 两组患者术后均获随访,时间6~21(14.0±2.8)个月。髓内钉组和钢板组比较,髓内钉组手术时间短、出血少、腓骨临床愈合时间短、切口感染率低(P<0.05)。髓内钉组术后出现2例延迟愈合,钢板组出现1例不愈合,2例延迟愈合。末次随访踝关节功能按照AOFAS评分标准,髓内钉组(88.33±4.57)分,优17例,良12例,可1例;钢板组(87.00±4.14)分,优16例,良10例,可4例;两组比较差异无统计学意义(P>0.05)。

结论: 弹性髓内钉治疗腓骨骨折,具有手术时间短、术中出血少、骨折愈合时间短和切口并发症少等优点。
[关键词]:弹性髓内钉  成人  胫腓骨骨折  骨折内固定
 
Comparative study of minimally invasive titanium elastic nail and steel plate on the treatment of fracture of tibiofibular fracture in adults
Abstract:

Objective To compare the clinical outcomes of using elastic intramedullary nail and plate to fix fibular fracture.

Methods The 60 patients with tibiofibular fractures admitted from January 2015 to December 2022 were divided into two groups:intramedullary nail group and plate group,30 cases each,intramedullary nail group was treated with elastic intramedullary nail fixation group,plate group was treated with steel plate and screw fixation group. Intramedullary nail group,there were 18 males and 12 females,aged from 22 to 75 years old with an average of (39.4±9.8) years old,including 24 cases of traffic accidents injury,6 cases of falling injury,23 cases of closed fractures,7 cases of open fractures. Steel plate group,there were 15 males and 15 females,aged from 24 to 78 years old with an average of (38.6±10.2) years old. The 22 cases were injured by traffic accident,8 cases were injured by falling. The 24 cases were closed fractures and 6 cases were open fractures. The operation time,intraoperative bleeding,American Orthopedic Foot and Ankle Society (AOFAS) ankle and hind foot scores,clinical healing time of fibula and the incidence of wound complications were compared between the two groups.

Results The patients in both groups were followed up for 6 to 21 months,with an average of (14.0±2.8) months. Compared with plate group,intramedullary nail group had shorter operative time,less bleeding,shorter clinical healing time of fibula,and lower infection rate of incision,and the difference was statistically significant (P<0.05). There were 2 cases of delayed healing in intramedullary nail group,1 case of nonunion in plate group,and 2 cases of delayed healing in plate group,and there was no statistically significant difference between the two groups (P>0.05). In the last follow-up,according to the AOFAS scoring standard,the ankle function in intramedullary nail group was excellent in 17 cases,good in 12 cases,fair in 1 case,with an average of (88.33±4.57) points,while in plate group,excellent in 16 cases,good in 10 cases,fair in 4 cases,with an average of (87.00±4.14) points;There was no statistical difference between the two groups (P>0.05).

Conclusion Elastic intramedullary nail has the advantages of short operation time,less intraoperative bleeding,short fracture healing time and less incision complications in the treatment of fibular fracture,which is worthy of clinical application.
KEYWORDS:Elastic intramedullary nail  Adults  Tibial and fibular fracture  Internal fixation
 
引用本文,请按以下格式著录参考文献:
中文格式:祝海炳,张永涛,吕和,任富昌,周成洪,应昀峰.微创弹性髓内钉和钢板内固定治疗成人胫腓骨骨折的病例对照研究[J].中国骨伤,2024,37(4):352~357
英文格式:ZHU Hai-bing,ZHANG Yong-tao,LYU He,REN Fu-chang,ZHOU Cheng-hong,YING Yun-feng.Comparative study of minimally invasive titanium elastic nail and steel plate on the treatment of fracture of tibiofibular fracture in adults[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(4):352~357
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