髓内钉治疗胫骨骨折的疗效观察.docVIP

精品论文 参考文献 髓内钉治疗胫骨骨折的疗效观察 苗杰 江苏省宜兴市第二人民医院 214221【摘 要】目的 观察髓内钉治疗胫骨骨折的临床疗效。方法 选择宜兴市第二人民医院骨科收治的胫骨中下段骨折患者40例，随机分为观察组和对照组两组，每组20 例。均采用交锁髓内钉治疗,观察组X 片检查见骨折线间隙lt;2 mm 时去掉远端锁钉，对照组持续静力化直至完全愈合。观察和比较两组患者的骨折愈合时间、踝关节、膝关节疼痛评分和关节功能恢复情况。 结果观察组随访2、3、6 个月骨折愈合率（50％、90％、100％）明显优于对照组(20％、60％、80％)，差异有统计学意义(Plt;0.05)。 　　术后6 个月观察组膝关节VAS 评分和疼痛率与对照组比较，差异均无统计学意义(Pgt;0.05)；对照组踝关节VAS 评分和疼痛率高于观察组，差异有统计学意义(Plt;0.05)；两组膝、踝关节功能评分比较，差异无统计学意义(Pgt;0.05)。结论 胫骨中下段骨折采用髓内钉内固定后适时动力化治疗，能有效提高骨愈合率，降低踝关节疼痛的发生率，而不影响关节功能，值得临床推广。 　　【关键词】髓内钉；胫骨骨折；动力化；静力化Abstract: Objective To observe the clinical effect of the treatment of tibial fractures with intramedullary nailing. Methods ChooseSecond Peoples Hospital of Yixing City, 40 cases of middle and distal tibial fractures were randomly divided into observation group andcontrol group, two cases in each group, 20 cases.X tablets in the observation group were treated with interlocking intramedullary nailing, andthe distal locking screws were removed from the 2mm, and the control group was continued until complete healing.The fracture healingtime, ankle joint, knee pain score and joint function recovery of the two groups were observed and compared.Results The fracture healing rate (50%,90%,100%) in the observation group was significantly better than that in the control group(20%,60%,80%), and the difference was statistically significant(Plt;0.05).The VAS score and pain score of knee joint in the observation groupwere compared with that of the control group at 6 months after operation, and the difference was not statistically significant(Plt;0.05).In thecontrol group, the VAS score and pain in the ankle joint was higher than that in the observation group, the difference was statisticallysignificant(Plt;0.05).Two groups of knee and ankle joint function score comparison, the difference was not statisticallysignificant(Pgt;0.05).Conclusion The treatment of posterior tibial fractures with intramedullary nailing, which can effectively improve therate of bone healing, and reduc