迟氏正骨手法闭合复位带锁髓内钉治疗胫腓骨骨折45例的临床观察

发布时间：2018-03-22 03:00

本文选题：胫腓骨骨折　切入点：闭合复位　出处：《辽宁中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过回顾性研究对“迟氏正骨”手法闭合复位带锁髓内钉治疗胫腓骨骨折的疗效进行分析,寻求治疗胫腓骨骨折合理有效的方式。材料与方法:对2014.5-2016.5期间入院后行髓内钉手术治疗的94例胫腓骨骨折患者进行回顾性分析。其中行“迟氏正骨”手法闭合复位带锁髓内钉治疗的患者45人,行切开复位钢板内固定术患者49人。分析比较两组患者骨折的手术时间,术后肿胀消退时间,骨折愈合时间、疗效评分等情况,进行统计学处理,并对其加以分析。结果:出院后对患者进行随访,随访时间6-13个月,平均为11.4个月。两组患者骨折均愈合。并发症方面比较,两组患者均未出现内固定物断裂,骨筋膜室综合征等并发症,切开复位内固定组患者出现3例切口感染;“迟氏正骨”手法组在骨折在手术时间,术后消肿,术后平均愈合时间都优于切开复位内固定术组。术后参照Johner-Wruhs评分对患者进行疗效评价,“迟氏正骨”手法组评分高于切开复位内固定组,但两组差异无统计学意义(P0.05),两种术式均为治疗此类骨折的有效方式。结论:迟氏正骨手法闭合复位带锁髓内钉治疗胫腓骨骨折具有术时短,感染风险低、术后肿胀消退快、骨折愈合时间短、术后功能评分高的优势。同时闭合复位,微创手术,符合现代骨科学的“CO”理论。手术复位无需借助牵引床,操作简便,为基层医院治疗该疾病提供一种可行的方法。
[Abstract]:Objective: to analyze the effect of closed reduction with locking intramedullary nail on tibia and fibula fracture by retrospective study. Materials and methods: 94 cases of tibia and fibula fracture treated by intramedullary nail operation during the period of 2014.5-2016.5 were analyzed retrospectively. 45 patients treated with interlocking intramedullary nailing, 49 patients were treated with open reduction and plate internal fixation. The time of operation, the time of swelling, the time of fracture healing, the score of curative effect and so on were analyzed and compared between the two groups. Results: the patients were followed up for 6-13 months with an average of 11.4 months. Complications such as osseous fascia syndrome, open reduction and internal fixation group showed 3 cases of incision infection. The average healing time after operation was better than that in the open reduction and internal fixation group. The curative effect was evaluated with Johner-Wruhs score. The score of Chi's bony manipulation group was higher than that of open reduction and internal fixation group. However, there was no significant difference between the two groups in the treatment of tibia and fibula fractures. Both operative methods were effective in the treatment of these fractures. Conclusion: the treatment of tibia and fibula fracture with interlocking intramedullary nail by Chi's orthopaedic manipulation has the advantages of short operative time, low risk of infection and quick regression of swelling after operation. The advantages of short healing time, high postoperative functional score, close reduction and minimally invasive surgery are in line with the "CO" theory of modern orthopedics. It provides a feasible method for the treatment of this disease in primary hospital.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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