[1]郎跃忠,刘勇.髓内钉与经皮锁定钢板治疗胫骨中下段骨折临床疗效分析[J].中华老年骨科与康复电子杂志,2020,(04):184-190.[doi:10.3877/cma.j.issn.2096-0263.2020.04.001]
　Lang Yuezhong,Liu Yong.[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2020,(04):184-190.[doi:10.3877/cma.j.issn.2096-0263.2020.04.001]
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髓内钉与经皮锁定钢板治疗胫骨中下段骨折临床疗效分析()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2020年04期
页码:
184-190
栏目:
骨与创伤
出版日期:
2020-08-05

文章信息/Info

作者:
郎跃忠; 刘勇
江苏省苏州高新区人民医院骨科
Author(s):
Lang Yuezhong;  Liu Yong
Department of Orthopaedics, The People’s Hospital of SND, Suzhou 215129, China
关键词:
胫骨骨折;  骨折固定术;  交锁髓内钉;  锁定钢板
Keywords:
Tibia fractures;  Fracture fixation;  Intramedullary nail nail;  Locking plate
DOI:
10.3877/cma.j.issn.2096-0263.2020.04.001
文献标志码:
A
摘要:
目的 比较髓内钉（IMN）与经皮锁定钢板（MIPPO）治疗胫骨中下段骨折的临床疗效。方法 回顾性分析2016年1月至2019年12月江苏省苏州高新区人民医院应用IMN与MIPPO两种手术方式治疗的胫骨中下段骨折患者共60例，其中IMN组30例，男性19例，女性11例；MIPPO组30例，男性21例，女性9例，比较两组患者在性别、年龄、受伤类型、OTA分型、受伤原因、是否合并开放性骨折、是否合并腓骨骨折、随访时间、术前等待时间、胫骨手术时间、胫骨术中透视次数、胫骨手术出血量、骨愈合时间、住院时间、手术并发症、术后Johner-Wruhs评分等方面的差异。结果 60例患者均获随访，随访时间12～26个月。与MIPPO组比较，IMN组术前等待时间、住院时间短，差异有统计学意义（P＜0.05）；两组胫骨手术时间、术中透视次数、手术出血量、骨愈合时间、Johner-Wruhs评分结果比较差异无统计学意义；髌前痛、软组织激惹、力线不良、骨不连、骨延迟愈合等并发症比较差异无统计学意义；伤口并发症发生率比较，IMN组低于MIPPO组，差异有统计学意义（P＜0.05）。结论 IMN与MIPPO两种固定方法均是治疗胫骨中下段骨折的有效方法。IMN内固定对皮肤软组织干扰小，更加适合用于局部软组织条件不良者。
Abstract:
Objective To compare the clinical efficacy of intramedullary nail (IMN) and minimally invasive percutaneous plate osteosynthesis (MIPPO) in the treatment of middle-distal tibial fractures. Methods A retrospective study was conducted on 60 middle-distal tibia fractures treated with IMN (30 cases) and MIPPO (30 cases) in our hospital from January 2016 to December 2019, the clinical effects of the two therapeutic method was compared. Results All the 60 patients were followed up for 12 to 26 months. Compared to MIPPO group, the preoperative waiting time and hospitalization time were shorter in IMN group, the differences were statistically significant (P<0.05). There were no statistically significant differences in tibial operation time, intraoperative fluoroscopy times, intraoperative blood loss, fracture healing time and Johner-Wruhs score between the two groups. There were no statistical difference in the complications of anterior knee pain, soft tissue irritation, malunion, bone nonunion and delayed union. The incidence of wound complications was lower in IMN group than in MIPPO group (P<0.05). Conclusions Both intramedullary nail and percutaneous locking plate are effective methods for the treatment of middle-distal tibia fractures. The intramedullary nail internal fixation has little interference to the skin and soft tissue, so it is more suitable for the patients with poor local soft tissue conditions.

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备注/Memo

备注/Memo:
基金项目：苏州高新区人民医院科学创新基金（SGY2019C02）
更新日期/Last Update: 2020-08-18