摘要
目的比较外固定支架与非扩髓髓内钉治疗开放性胫骨骨折的临床疗效。方法对2002年1月～2004月12月急诊治疗的156例开放性胫骨骨折患者资料进行回顾性分析，其中93例采用单臂外固定支架治疗，63例采用非扩髓髓内钉治疗。对两组患者的一般资料、骨折AO分型、软组织Gustilo分型、术后骨折愈合时间、骨折延迟愈合例数及并发症进行统计学分析。结果外固定支架组和非扩髓髓内钉组的骨折平均愈合时间分别为7．8个月（3～18个月）、5．3个月（2．12个月）。非扩髓髓内钉组在骨折愈合时间、骨折延迟愈合及骨折畸形愈合方面明显优于单臂外固定支架组（P〈0．05）；两组在感染发生率方面差异无统计学意义（P〉0．05）。结论非扩髓髓内钉治疗开放性胫骨骨折具有骨折愈合时间短、畸形愈合少等优点。对于严重污染的创面及全身多发伤患者，外固定支架的临时固定是首选。
Objective To compare the clinical results of unreamed intramedullary nailing and mono-lateral external fixation for the treatment of open tibial fractures. Methods Ninety-seven patients who had received mono-external fixation and 63 ones who had unreamed intramedullary nailing in our hospital between January 2002 to December 2004 were involved in our retrospective investigation. The clinic data, AO fracture type, Gustilo soft tissue type, healing time and complications of the 2 groups of patients were all statistically compared in our study. Results Most fractures, including Grades Ⅰ to ⅢB, were caused by high energy trauma. There were 3 deep and 6 superficial infections in the nailing group and 5 deep and 9 superficial infections in the external fixation group. The difference between the 2 groups was not significant. In addition, 6 patients in the external fixation group had severe pin track infection. The mean time of union was 5 months in the nailing group and 8 months in the external fixation group. The incidence of delayed union in the external fixation group was twice as high as in the nailing group. The surgical procedures performed to promote union was 4 times higher in the external fixation group. Conclusion The unreamed intramedullary nailing is superior to external fixation in the treatment of most open tibial fractures.
出处
《中华创伤骨科杂志》
CAS
CSCD
2007年第7期634-637,共4页
Chinese Journal of Orthopaedic Trauma
关键词
胫骨
骨折
开放性
骨折固定术
内固定器
外固定器
Tibia
Fractures, open
Fracture fixation
Internal fixators
External fixators
