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交锁髓内钉与锁定钢板治疗胫骨远端关节外骨折的疗效比较 被引量:18

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摘要 目的比较交锁髓内钉与锁定钢板内固定治疗胫骨远端骨折的疗效。方法回顾性分析2006年2月至2012年8月因胫骨远端关节外骨折接受手术治疗的患者的疗效,所有患者均接受急诊手术,透视下复位,依据内固定方式分为交锁髓内钉组(n=47)和锁定钢板组(n=42),比较2组一般资料、骨折类型、手术时间、术中出血量、隐性失血量、术中透视次数、骨折愈合时间、末次随访踝关节功能评分及并发症发生率。术前、术后1 d及术后7 d常规检查血常规、ESR、CRP及PCT了解全身炎性反应情况。结果 2组患者性别比、年龄、骨折类型分布差异无统计学意义(P〉0.05)。85例患者获得随访,随访13~28个月,平均20.5个月。2组患者手术时间差异无统计学意义(P〉0.05);髓内钉组术中出血量低于钢板组,然而术后隐性失血、总失血量及术中透视次数大于钢板组;所有患者均获得骨性愈合,交锁髓内钉组愈合时间(21.8±4.6)周,经皮锁定钢板组(18.8±4.1)周。末次随访踝关节功能评分均为优良,2组差异无统计学意义(P〉0.05)。髓内钉组发生骨髓炎3例、钢板组1例;髓内钉组发生延迟愈合6例、钢板组1;髓内钉组有发生畸形愈合4例,经皮钢板组有发生局部软组织感染4例。术后24 h髓内钉组ESR及CRP水平显著高于经皮钢板组(P〈0.05)。结论交锁髓内钉与锁定钢板治疗胫骨远端关节外骨折均能获得良好临床疗效,交锁髓内钉有利于处理伴发局部软组织严重损伤的骨折,但有固定后畸形愈合、延迟愈合和骨髓炎增加的风险。因而对于局部软组织条件好的胫骨远端关节外骨折,锁定钢板更具优势。
出处 《河北医药》 CAS 2015年第19期2960-2963,共4页 Hebei Medical Journal
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