带锁髓内钉与LISS钢板治疗小腿中下段骨折的临床观察

发布时间：2018-01-18 15:46

本文关键词：带锁髓内钉与LISS钢板治疗小腿中下段骨折的临床观察　出处：《山东中医药大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:观察应用带锁髓内钉与LISS钢板治疗小腿中下段骨折的临床效果,探讨小腿中下段骨折治疗方式的选择。方法:回顾性对我院骨科自2012年2月至2014年12月收治的40例新鲜小腿中下段骨折通过不同手术方法治疗后,观察评估患肢的功能恢复情况,以Johner-Wruhs胫骨干骨折评定标准作为评定标准,两种手术方法的观察变量为手术持续时间、术中出血量、术后消肿时间、刀口愈合时间、住院时间。纳入病例为40例,带锁髓内钉固定组20例、LISS钢板组20例。40例患者,14~87岁,平均年龄45.25岁。结果:手术40例患者全部随访,随访时间为3至8个月,平均5个月,全部患者均未出现内固定失效及术后并发症。末次随访时根据Johner-Wruhs评分,带锁髓内钉固定组优14例,良3例,可3例,优良率达到85%;LISS钢板固定组优14例,良2例,可4例,优良率达到80%,均取得较好的治疗效果。两组的手术持续时间为:带锁髓内钉组为(76.95±5.925)分钟,LISS钢板组为(69.75±4.266)分钟,结果经χ2检验,P0.05,有统计学意义,LISS钢板组所用手术时间少于带锁髓内钉组。两组的术中出血量为:带锁髓内钉组为(88.15±4.932)ml,LISS钢板组为(127.1±6.972)ml,结果经χ2检验,P0.05,有统计学意义,LISS钢板组术中出血量多于带锁髓内钉组。两组的消肿时间为:髓内钉组为(5.15±0.988)天,LISS钢板组为(8.05±0.945)天,结果经χ2检验,P0.05,有统计学意义,LISS钢板组术后消肿时间多于带锁髓内钉组。两组的刀口愈合时间为:带锁髓内钉组为(14.05±0.826)天,LISS钢板组为(14±0.725)天,结果经χ2检验,P0.05,没有统计学意义。两组的住院时间为:带锁髓内钉组为(15.85±1.496)天,LISS钢板组为(15.95±0.808)天,结果经χ2检验,P0.05,没有统计学意义。结论:带锁髓内钉和LISS钢板对治疗小腿中下段骨折均可以取得良好的固定效果,带锁髓内钉组术中出血量、刀口愈合时间及术后消肿时间较LISS钢板组有优势,而LISS钢板组在手术时间方面比带锁髓内钉组快。
[Abstract]:Objective: to observe the clinical effect of interlocking intramedullary nail and LISS plate in the treatment of middle and lower leg fracture. To explore the choice of treatment methods for middle and lower leg fractures. From February 2012 to December 2014, 40 cases of fresh middle and lower leg fractures were treated by different surgical methods. The functional recovery of the affected limb was evaluated. The evaluation criteria of Johner-Wruhs tibial shaft fracture were used as the evaluation criteria. The operative duration and the amount of intraoperative bleeding were observed as the two operative variables. 40 cases were included, 20 cases were treated with interlocking intramedullary nail fixation, 20 cases were treated with Liss steel plate, 20 cases were aged 1487 years. Results: all 40 patients were followed up for 3 to 8 months (mean 5 months). According to Johner-Wruhs score, 14 cases were excellent, 3 cases were good and 3 cases were fair in the group with interlocking intramedullary nail. The excellent and good rate reached 85. LISS plate fixation group was excellent in 14 cases, good in 2 cases and fair in 4 cases. The excellent and good rate was 80%. The operative duration was 76.95 卤5.925 minutes in the interlocking intramedullary nail group and 69.75 卤4.266 minutes in the Liss plate group. Results 蠂 2 test showed that P 0.05 had statistical significance. The operative time in the LISS plate group was less than that in the intramedullary nail group, and the intraoperative blood loss was 88.15 卤4.932 ml in the intramedullary nail group. The LISS plate group was 127.1 卤6.972 ml, the results were statistically significant by 蠂 2 test (P 0.05). The amount of intraoperative bleeding in the LISS plate group was more than that in the intramedullary nail group, and the detumescence time was 5.15 卤0.988 days in the intramedullary nail group. The LISS plate group was 8.05 卤0.945 days. The results were statistically significant by 蠂 2 test (P 0.05). The time of detumescence in the LISS plate group was longer than that in the intramedullary nail group, and the healing time of the knife edge in the two groups was 14.05 卤0.826 days. The LISS plate group was 14 卤0.725 days. The hospitalization time of the two groups was 15.85 卤1.496 days in the interlocking intramedullary nail group and 15.95 卤0.808 days in the Liss plate group. The results were analyzed by 蠂 2 test. P 0.05, no statistical significance. Conclusion: intramedullary nail with locking and LISS plate can achieve a good fixation effect in the treatment of middle and lower leg fractures, the intraoperative bleeding volume of intramedullary nail with locking nail group. The wound healing time and postoperative detumescence time were superior to those of LISS plate group, while the operation time of LISS plate group was faster than that of interlocking intramedullary nail group.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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