| 朱运良,李磊,周咏辉,李冲,方诗元.髓内钉联合单皮质钢板固定治疗胫骨干骨折的效果[J].中国临床保健杂志,2023,26(3):371-375. |
| 髓内钉联合单皮质钢板固定治疗胫骨干骨折的效果 |
| Clinical observation on the treatment of tibial shaft fractures with intramedullary nail and single cortical plate fixation |
| 投稿时间：2023-03-25 |
| DOI：10.3969/J.issn.1672-6790.2023.03.019 |
| 中文关键词: 胫骨骨折 骨折固定术 疼痛测定 手术后并发症 手术时间 |
| 英文关键词: Tibial fractures Fracture fixation Pain measurement Postoperative complications Operative time 〖FL |
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| 中文摘要: |
| 目的 比较髓内钉联合单皮质钢板固定与仅髓内钉固定治疗胫骨干骨折的临床疗效。方法 回顾性分析2017年1月1日至2022年1月1日纳入的72例在安徽医科大学附属省立医院行手术治疗的胫骨干骨折患者的临床资料,根据术式的不同将患者分为IMN组(仅髓内钉固定组)40例与IMN&PLA组(髓内钉联合单皮质钢板固定组)32例。比较2组患者的手术时间,术中出血量,骨折愈合时间,术后完全负重下地时间,术后并发症发生情况,术后3、6、12个月的视觉模拟评分法(VAS)评分和膝踝关节Johner-Wruhs功能评分。结果 IMN&PLA组手术时间短于IMN组,术后6个月VAS评分小于IMN组(P<0.05),而在术中出血量、骨折愈合时间、术后完全负重下地时间以及术后并发症发生率和功能优良率上,2组差异无统计学意义。结论 胫骨干骨折采取仅髓内钉固定与联合使用髓内钉加单皮质钢板内固定均可获得较好的治疗效果,但在选择时仍需根据骨折类型、局部软组织状况选择最佳治疗措施。并且在皮肤及软组织条件较好的基础上,多段胫骨骨折者或闭合复位困难者选择髓内钉联合单皮质钢板内固定更具优势。 |
| 英文摘要: |
| Objective To observe and compare the clinical efficacy of intramedullary nail combined with single cortical steel plate fixation and intramedullary nail fixation alone in the treatment of tibial shaft fractures.Methods A retrospective analysis was conducted on the clinical data of 72 patients with tibial shaft fractures who underwent surgical treatment in our hospital from January 1,2017 to January 1,2022.According to different surgical procedures,the patients were divided into an IMN group (Intramedullary nail group,i.e.intramedullary nail fixation only group) of 40 cases and an IMN&PLA group (Intramedullary nail&Plate group,i.e.intramedullary nail combined with single cortical steel plate fixation group) of 32 cases.Compare the surgical time,intraoperative bleeding volume,fracture healing time,time to complete weight-bearing landing after surgery,incidence of postoperative complications,VAS scores at 3,6,and 12 months after surgery,and Johner Wruhs functional scores of the knee and ankle joints between the two groups of patients.Results The surgery time in the IMN&PLA group was shorter than that in the IMN group,and the VAS score at 6 months after surgery was lower than that in the IMN group (P<0.05).However,there was no statistically significant difference between the two groups in terms of surgical bleeding volume,postoperative fracture healing time,complete weight-bearing time of the affected limb,as well as the incidence of postoperative complications and the rate of functional excellence.Conclusions Both intramedullary nail fixation alone and combined use of intramedullary nail and single cortical steel plate fixation can achieve good treatment results for tibial shaft fractures.However,the optimal treatment measures still need to be selected based on the type of fracture and local soft tissue condition.Moreover,on the basis of good skin and soft tissue conditions,it is more advantageous for patients with multiple tibial fractures or those with difficulty in closed reduction to choose intramedullary nails combined with single cortical steel plates for internal fixation. |
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