带锁髓内钉与经皮微创钢板治疗胫骨干多段骨折的临床比较.docVIP

带锁髓内钉与经皮微创钢板治疗胫骨干多段骨折的临床比较 　　摘要：目的 比较带锁髓内钉和经皮微创钢板两种内固定方法治疗胫骨干多段骨折的优缺点，为临床治疗提供参考。方法 选取2013年1月～2015年1月我科收治的胫骨干多段骨折患者59例，分为带锁髓内钉组和经皮微创钢板组。观察两组手术时间、术中出血量、透视次数、术后并发症、骨折临床愈合时间，比较带锁髓内钉与经皮微创钢板的治疗效果。结果 两组各有1例患者术后失访，其余患者均随访19～27w（平均22.4w），骨折均愈合。带锁髓内钉组与经皮微创钢板组相比，两组手术时间、术中出血量、术中透视次数、骨折临床愈合时间之间差异显著，具有统计学意义（P0.05）。结论 带锁髓内钉内固定较经皮微创钢板治疗胫骨干多段骨折的手术时间较长、术中出血量较多、透视次数较多、但骨折临床愈合时间短。并发症发生率无显著差别。 　　关键词：胫骨髓内钉；经皮微创钢板；胫骨干多段骨折 　　Abstract：Objective To compare the advantages and disadvantages of interlocking intramedullary nail and minimally invasive percutaneous plate osteosynthesis in the treatment of tibia fracture.Methods 59 cases of tibia fracture，treated from 2013.01 to 2015.01，were randomly divided into two groups，one group were treated with interlocking intramedullary nail，and the other were treated with minimally invasive percutaneous plate osteosynthesis.The operation time，blood loss cases，the number of perspective，postoperative complications，and fracture healing time were observered to comparer the efficacy of interlocking intramedullary nail and minimally invasive percutaneous plate osteosynthesis in the treatment of tibia fracture.Results Except 1 person in each group was lost follow-up， The other patients were followed up for 19～27 weeks （average 22.4 weeks）， and their fracture have healed.we found obvious difference between two groups according to the date of the operation time，blood loss cases，the number of perspective，and fracture healing time（P0.05）. Conclusion The group treated with interlocking intramedullary nail has longer operation time，more blood loss cases，more number of perspective， but shorter fracture healing time. And in the aspects of postoperative complications，the two groups had no significant difference. 　　Key words：Interlocking intramedullary nail； Minimally invasive percutaneous plate osteosynthesis； Tibial fractures 　　胫骨干骨折是骨创伤中最常见的骨折之一。当暴力直接作用于胫骨干时，常出现胫骨干多段粉碎性骨折。目前胫骨干骨折的治疗主要采用微创内固定治疗，主要有带锁髓内钉及经皮微创钢板两种内固定方式。笔者选取 2013年1月～2015年1 月我科收治的胫骨干多段骨折患者 59 例，根据内