可吸收钉板与金属材料固定治疗内外踝骨折的对比性研究
发布时间：2018-09-04 18:25
【摘要】：目的:比较可吸收钉板与金属材料固定治疗内外踝骨折疗效,为内外踝骨折患者手术内固定材料的选择提供依据。方法:本研究选取我院2013年1月~2014年12月71例内外踝骨折患者,这些病例均由同一治疗小组收治,将其分成两组,分别是金属材料组(Metal materials internal fixation,MIF)和可吸收钉板组(Absorbable nail plate,ANP),其中金属组36例,材料选用外踝锁定解剖板和拉力螺钉,MIF组术中检查少部分病例内固定不够牢靠,术后予以石膏外固定6周。可吸收钉板组35例,材料使用可吸收钉板系统,ANP组术后常规石膏外固定6周。在完整的71例内外踝骨折患者中男33例33踝,女38例38踝,左踝36例,右踝35例;年龄20-60岁,平均39.20岁;Weber分型A、B、C型骨折分别为25、29、17例。对两组病例的年龄,术后1、2、3、6、12个月骨痂最大直径,术后1、2、3、6、12个月X线灰度值和术后2、3、6、12个月踝关节评分进行比较。结果:MIF组和ANP组各有一例患者出现轻度创伤性关节炎,金属材料组有一例患者骨折延迟愈合。所有病例均未出现感染。MIF组内固定物无松动断裂。两组病例均无骨不连等并发症。两组病例在年龄、12个月骨痂最大直径、12个月骨痂X线灰度值、3个月踝关节评分、6个月踝关节评分、及12个月踝关节评分方面比较,差异无统计学意义;而在1、2、3、6个月骨痂最大直径和1、2、3、6个月骨痂X线灰度值以及2个月踝关节评分方面比较,差异有统计学意义。结论:结果显示,内外踝骨折的手术治疗中,可吸收材料可以达到固定骨折的效果,且在术后2、3、6个月时ANP组的骨痂量比MIF组多,ANP组的骨痂密度比MIF组高,从而反映出在骨痂生长时期,ANP组的骨折愈合能力优于MIF组,在2、3、6、12个月踝关节功能评分无差病例,从而反映出可吸收钉板对踝关节的近期与远期功能无影响。
[Abstract]:Objective: to compare the efficacy of absorbable nail plate and metal fixation in the treatment of medial and lateral malleolus fractures and to provide evidence for the selection of internal fixation materials for patients with medial and lateral malleolus fractures. Methods: from January 2013 to December 2014, 71 patients with medial and lateral malleolus fractures were treated by the same treatment group and divided into two groups. Metal material group (Metal materials internal fixation,MIF) and absorbable nail plate group (Absorbable nail plate,ANP). Among them, 36 cases of metal group were treated with lateral malleolus locking anatomic plate and pull screw group. The internal fixation was not reliable enough in a few cases during operation, and was treated with plaster external fixation for 6 weeks after operation. The absorbable nail plate group (35 cases) was treated with absorbable nail plate system (ANP) for 6 weeks. Of the 71 patients with medial and lateral malleolus fractures, 33 were males, 38 were females, 36 were left malleolus, and 35 were right malleolus. The age, the maximum callus diameter at 12 months, the X ray gray value at 12 months and the ankle joint score at 12 months were compared between the two groups. Results one case of mild traumatic arthritis was found in the ANP group and one case was delayed union in the metal material group. No loose breakage was found in all cases in the infection. MIF group. There were no nonunion complications in both groups. There was no significant difference in age, maximum callus diameter at 12 months, X-ray gray value of callus in 12 months, ankle joint score at 3 months, ankle joint score at 6 months and ankle joint score at 12 months. There were significant differences in the maximum callus diameter at 6 months, X ray gray value at 6 months and ankle joint score at 2 months. Conclusion: the results showed that absorbable materials could achieve the effect of fixation in the surgical treatment of medial and lateral malleolus fractures, and the callus density of ANP group was higher than that of MIF group at 3 and 6 months after operation. The results showed that the fracture healing ability of the MIF group was better than that of the MIF group during callus growth, and the functional score of the ankle joint was no difference in the second trimester and 12 months, which showed that the absorbable nail plate had no effect on the short-term and long-term function of the ankle joint.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3
本文编号：2222985
[Abstract]:Objective: to compare the efficacy of absorbable nail plate and metal fixation in the treatment of medial and lateral malleolus fractures and to provide evidence for the selection of internal fixation materials for patients with medial and lateral malleolus fractures. Methods: from January 2013 to December 2014, 71 patients with medial and lateral malleolus fractures were treated by the same treatment group and divided into two groups. Metal material group (Metal materials internal fixation,MIF) and absorbable nail plate group (Absorbable nail plate,ANP). Among them, 36 cases of metal group were treated with lateral malleolus locking anatomic plate and pull screw group. The internal fixation was not reliable enough in a few cases during operation, and was treated with plaster external fixation for 6 weeks after operation. The absorbable nail plate group (35 cases) was treated with absorbable nail plate system (ANP) for 6 weeks. Of the 71 patients with medial and lateral malleolus fractures, 33 were males, 38 were females, 36 were left malleolus, and 35 were right malleolus. The age, the maximum callus diameter at 12 months, the X ray gray value at 12 months and the ankle joint score at 12 months were compared between the two groups. Results one case of mild traumatic arthritis was found in the ANP group and one case was delayed union in the metal material group. No loose breakage was found in all cases in the infection. MIF group. There were no nonunion complications in both groups. There was no significant difference in age, maximum callus diameter at 12 months, X-ray gray value of callus in 12 months, ankle joint score at 3 months, ankle joint score at 6 months and ankle joint score at 12 months. There were significant differences in the maximum callus diameter at 6 months, X ray gray value at 6 months and ankle joint score at 2 months. Conclusion: the results showed that absorbable materials could achieve the effect of fixation in the surgical treatment of medial and lateral malleolus fractures, and the callus density of ANP group was higher than that of MIF group at 3 and 6 months after operation. The results showed that the fracture healing ability of the MIF group was better than that of the MIF group during callus growth, and the functional score of the ankle joint was no difference in the second trimester and 12 months, which showed that the absorbable nail plate had no effect on the short-term and long-term function of the ankle joint.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3
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