交锁髓内钉和加压钢板治疗胫骨中下段骨折的临床疗效观察

发布时间：2018-07-23 15:06

【摘要】：目的：通过观察对比分析交锁髓内钉和加压钢板治疗胫骨中下段骨折的临床疗效,探讨胫骨中下段骨折的治疗方案,为临床治疗提供经验。材料与方法：选取2013年3月至2014年8月期间,在沈阳市骨科医院微创骨科病房住院经同一个医生手术治疗的胫骨中下段骨折、AO分型为Bl型的患者42例作为研究对象,按照患者入院顺序,随机分为交锁髓内钉组(A组)与加压钢板组(B组),每组21例。术后给予患者抗生素静点预防感染,脱水药静点促进消肿,口服利伐沙班预防下肢深静脉血栓形成,口服接骨药促进骨折愈合等治疗,并指导其功能锻炼。观察并记录两组手术时间、切口长度、术中出血量、开始负重时间、骨折愈合时间、膝、踝关节功能恢复等,并详细记录获得的数据,最后用SPSS17.0统计软件对所得数据进行统计学分析。结果：1.两组患者在性别、年龄、致伤原因、骨折类型、骨折部位方面比较,P0.05,差异无统计学意义,具有可比性。2.两组在手术时间、术中出血量、切口长度、开始负重时间及骨折愈合时间的比较,P0.05,差异有统计学意义,表明髓内钉组在手术时间、术中出血量、切口长度、开始负重时间及骨折愈合时间等方面优于加压钢板组。3.两组术后在膝、踝关节功能恢复的比较,P0.05,差异有统计学意义,表明髓内钉组在膝、踩关节功能恢复方面优于加压钢板组。结论：1与加压钢板治疗方法比较,交锁髓内钉具有手术时间短、切口小、术中出血量少、开始负重时间短等优势。2.与加压钢板治疗方法比较,交锁髓内钉具有骨折愈合时间短的优势。3.与加压钢板治疗方法比较,交锁髓内钉具有膝、踝关节功能恢复时间短的优势。
[Abstract]:Objective: to compare and analyze the clinical effect of interlocking intramedullary nail and compression plate in the treatment of middle and lower tibial fractures, and to explore the treatment scheme of middle and lower tibia fractures, and to provide experience for clinical treatment. Materials and methods: from March 2013 to August 2014, 42 patients with middle and lower tibial fractures classified as Bl type in the minimally invasive orthopedic ward of Shenyang Orthopaedics Hospital were selected. According to the order of admission, the patients were randomly divided into interlocking intramedullary nail group (group A) and compression plate group (group B) with 21 cases in each group. After operation, patients were given antibiotics to prevent infection, dehydration drugs to promote detumescence, oral rivastaban to prevent deep venous thrombosis of lower extremity, oral osteosynthesis to promote fracture healing, and to guide their functional exercise. The time of operation, length of incision, amount of blood lost during operation, time of starting load, time of fracture healing, functional recovery of knee and ankle were observed and recorded. Finally, the statistical analysis of the data is carried out with SPSS17.0 software. The result is 1: 1. There was no significant difference in sex, age, cause of injury, fracture type and fracture site between the two groups (P 0.05). There were significant differences between the two groups in operation time, intraoperative bleeding volume, incision length, starting weight loading time and fracture healing time (P 0.05), which indicated that intramedullary nail group had significant difference in operation time, intraoperative bleeding volume and incision length. The loading time and fracture healing time were better than that of compression plate group. 3. The difference of functional recovery of knee and ankle joint between the two groups was statistically significant, which indicated that the functional recovery of knee joint and trampling joint in intramedullary nail group was better than that in compression plate group. Conclusion compared with the treatment of compression plate, the interlocking intramedullary nail has the advantages of short operation time, small incision, less blood loss during operation, and short time of starting weight bearing. Compared with compression plate, interlocking intramedullary nail has the advantage of shorter healing time. Compared with compression plate, interlocking intramedullary nail has advantages of short recovery time of ankle joint and knee joint.
【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】：2015
【分类号】：R687.3

【相似文献】