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[1]葛波涌,王玉波,王明太,等.交鎖髓內(nèi)釘內(nèi)固定治療脛骨干骨折的臨床研究[J].中醫(yī)正骨,2015,27(10):8-10.
　GE Boyong,WANG Yubo,WANG Mingtai,et al.Clinical study on the internal fixation with interlocking intramedullary nail for the treatment of tibial shaft fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(10):8-10.
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交鎖髓內(nèi)釘內(nèi)固定治療脛骨干骨折的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期數(shù):
2015年10期
頁碼:
8-10
欄目:
臨床研究
出版日期:
2015-10-30

文章信息/Info

Title:
Clinical study on the internal fixation with interlocking intramedullary nail for the treatment of tibial shaft fractures
作者:
葛波涌; 王玉波; 王明太; 楊穎; 周鹿安; 劉鄭和
鄭州大學(xué)第二附屬醫(yī)院,河南 鄭州 450003
Author(s):
GE Boyong; WANG Yubo; WANG Mingtai; YANG Ying; ZHOU Luan; LIU Zhenghe
The Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,Henan,China
關(guān)鍵詞:
脛骨骨折;  骨折固定術(shù); 髓內(nèi);  治療; 臨床研究性
Keywords:
tibial fractures;  fracture fixation; intramedullary;  therapies; investigational
摘要:
目的:觀察交鎖髓內(nèi)釘內(nèi)固定治療脛骨干骨折的臨床療效和安全性。方法:將符合要求的80例脛骨干骨折患者隨機分為2組,每組40例,分別采用交鎖髓內(nèi)釘和外固定架固定治療。術(shù)后比較2組患者的骨痂出現(xiàn)時間、骨折愈合時間、臨床療效及并發(fā)癥發(fā)生率,臨床療效評定采用Johner-Wruhs脛骨干骨折療效標(biāo)準(zhǔn)。結(jié)果:所有患者均獲隨訪,隨訪時間7～25個月,中位數(shù)10個月。交鎖髓內(nèi)釘組骨痂出現(xiàn)時間和骨折愈合時間均短于外固定架組[(38.1±4.2)d,(53.4±5.1)d,t=7.398,P=0.013;(136.1±10.0)d,(193.5±8.3)d,t=8.654,P=0.011]; 末次隨訪時按照J(rèn)ohner-Wruhs脛骨干骨折療效標(biāo)準(zhǔn)評定,交鎖髓內(nèi)釘組優(yōu)20例、良9例、可9例、差2例,外固定架組優(yōu)12例、良9例、可15例、差4例,交鎖髓內(nèi)釘組的臨床療效優(yōu)于外固定架組(R^-交鎖髓內(nèi)釘組=35.52,R^-外固定架組=45.48,Z=-2.021,P=0.043)。至隨訪結(jié)束時,交鎖髓內(nèi)釘組2例發(fā)生切口感染、1例發(fā)生骨折延遲愈合、1例發(fā)生斷釘,外固定架組6例發(fā)生切口感染、4例發(fā)生骨折延遲愈合; 2組患者的并發(fā)癥發(fā)生率比較,差異無統(tǒng)計學(xué)意義(χ2=3.117,P=0.077)。結(jié)論:采用交鎖髓內(nèi)釘內(nèi)固定治療脛骨干骨折,骨折愈合快、療效確定、安全性高,值得臨床推廣應(yīng)用。
Abstract:
Objective:To observe the clinical curative effects and safety of internal fixation with interlocking intramedullary nail for the treatment of tibial shaft fractures.Methods:Eighty patients with tibial shaft fractures enrolled in the study were randomly divided into 2 groups,40 cases in each group,and the patients were treated with interlocking intramedullary nail internal fixation(group A)and frame external fixation(group B)respectively.The occurrence time of bony callus,fracture healing time,clinical curative effects and complication incidences were compared between the 2 groups after the operation,and the clinical curative effects were evaluated by using Johner-Wruhs standard for therapeutic effectiveness evaluation of tibial shaft fractures.Results:The patients in the 2 groups were followed up for 7-25 months with a median of 10 months.The occurrence time of bony callus and fracture healing time were shorter in group A compared to group B(38.1+/-4.2 vs 53.4+/-5.1 days,t=7.398,P=0.013; 136.1+/-10.0 vs 193.5+/-8.3 days,t=8.654,P=0.011).Twenty patients obtained an excellent result,9 good,9 fair and 2 poor in group A; while 12 patients obtained an excellent result,9 good,15 fair and 4 poor in group B according to Johner-Wruhs standard for therapeutic effectiveness evaluation of tibial shaft fractures at last follow-up.The group A surpassed the group B in the total curative effects(R^-group A=35.52,R^-group B=45.48,Z=-2.021,P=0.043).The incision infection(2 patients),delayed union of fracture(1 patient)and breakage of nail(1 patient)were found in group A; while incision infection(6 patients)and delayed union of fracture(4 patients)were found in group B during the follow-up period.There was no statistical differences in the rate of complications between the 2 groups(χ2=3.117,P=0.077).Conclusion:Interlocking intramedullary nail internal fixation has such advantages as short fracture healing time and definite curative effects and safety for treatment of tibial shaft fractures,so it is worthy of popularizing in clinic.

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備注/Memo:
2015-06-19收稿 2015-07-18修回
更新日期/Last Update: 2015-10-30