三种内固定方式治疗胫骨骨折的临床疗效研究Clinical Study on Three Kinds of Internal Fixation in Treating Tibial Fracture.pdfVIP

提 要 目的：对比分析三种内固定方式治疗胫骨骨折的优缺点。 方法：收集2009年12月～2011年12月在山东中医药大学附属医院骨科病房收治的 符合纳入标准的胫骨骨折患者94例，分别采用切开复位动力加压钢板(DCP)内固定、 闭合复位微创经皮LCP钢板内固定与闭合复位带锁髓内钉内固定治疗。经治疗均达到 骨折临床愈合标准，所有患者治疗后进行随访，随访结束后对各组进行Johner-Wruhs 评分，对比观察各组临床疗效。 结果：切开复位动力加压钢板(DCP)内固定、闭合复位微创经皮LCP 钢板内固定 与闭合复位带锁髓内钉内固定治疗胫骨骨折均疗效显著，优良率分别达到 74.2%、 93.8%和 93.6%，微创经皮 LCP 钢板组与带锁髓内钉组优良率明显高于动力加压钢板 (DCP)组，对比有显著的统计学差异（P＜0.05）；微创经皮LCP 钢板组与带锁髓内钉 组优良率相近，比较差别不具有统计学意义（P＞0.05）。 结论：切开复位动力加压钢板(DCP)内固定、闭合复位微创经皮LCP 钢板内固定 与闭合复位带锁髓内钉内固定均是治疗胫骨骨折的有效的方法，但闭合复位微创经皮 LCP 钢板内固定与闭合复位带锁髓内钉内固定疗效更好，在临床应根据具体情况选择 合适的手术时机和手术方式。 关键词 胫骨骨折；动力加压钢板；DCP；微创经皮LCP钢板；MIPPO；带锁髓内 钉；内固定。 Clinical Curative Effect Study of Three Kinds of Tibia Fracture Internal Fixation Speciality: Orthopedics of TCM Author:Mao Rui Hu Tutor: Prof Qi Shang Feng Abstract Objective：To discuss the clinical efficacy of the three kinds of tibia fracture internal fixation. Methods ：Collect 94 patients with tibial fracture who met the inclusion criteria from Affiliated Hospital of Shandong University of Traditional Chinese Medicine Orthopedic from 2009.12 to 2011.3.Treated with three approaches as internal surgical approach by Open reduction and dynamic compression plate ( DCP ) internal fixation, closed reduction and minimally invasive percutaneous LCP plate internal fixation with closed reduction and interlocking intramedullary nail.All patients were up to the fracture healing standard after treatment and followed up after treatment.After the end of follow-up were carried out in Johner-Wruhs score ， each group was observed and compared the clinical curative effect. Results ：Open reduction and dynamic compression plate ( DCP ) internal fixation, closed reduction and minimally invasi