摘要
目的探讨成人胫骨骨折的手术治疗效果。方法对2005年6月至2011年1月收治的81例成人胫骨干骨折患者,40例予髓内钉内固定,41例予胫骨加压钢板内固定,通过术中观察及术后随访,分析胫骨干骨折的手术疗效。结果患者均获随访,时间6～36个月,平均15个月。据Johner-Wruh评分标准,优秀61例,良好15例,可以2例,差3例,优良率为93.8%。5例发生感染,伤口经清创后延期愈合,余伤口均Ⅰ期愈合。术后无心、脑、肺、肾等明显并发症发生。骨折均获骨性愈合,时间4～8个月,平均5个月。①髓内钉组:平均术时130 min,出血量150 ml,切口长12 cm,3例发生浅表伤口感染。术后2周扶拐下床活动,有1例骨不连者经再手术后恢复。无钉断裂、松动等。据骨折愈合标准,骨性愈合时间3～7个月,平均5个月,优良率为95.0%。②钢板组:平均术时105 min,出血量200 ml,切口长度15 cm。浅表及深部伤口感染各1例,经清创后伤口延期愈合。术后2周扶拐下床,后期2例出现钢板螺钉松动致骨折分离不愈合,再次手术后恢复。骨折骨性愈合时间4～9个月,平均5.2个月,优良率为92.7%。结论成人胫骨干骨折手术疗效良好。髓内钉或加压钢板内固定用于治疗成人胫骨干骨折各有优势。
Objective To investigate the effect of surgical treatment of tibia shaft fracture. Methods From June 2005 to January 2011, 81 adult patients who suffered from fracture of the tibia shaft were investigated. Forty cases were fixation with in- i terlocking nail, 41 cases were fixation with compression plate. All patients were observed during operation and followed-up for an average period of 15 months （ range from 6 to 36 months）. Results According to judet standard on healing of fracture of Johner- Wruh, the functional scores were excellent in 61 cases, good in 15 cases, fair in 2 cases, and poor in 3 cases. The excellent- good rate was 93.8%. Five cases incisions had infection and healed after debridement, other wounds healed on time. No impor- tant morbidity of post-operative of heart, head, lung, etc. The average time of healing in all the cases was 5 months （from 4 to 8 months）. （!）Interlocking nail group： the average time during the operation was 2. 10 hours, the average amount of bleeding was 150 ml, The average length of incision was 12 cm. Three cases incision had superficial infection and healed after debridement , The cases were allowed to walk by stick after 2 weeks of post-operative, There was 1 case who suffered from nonunion of fracture and was salvaged with uneventful recovery, but implant loosening , nail and screw broken was not found in the followed-up peri- od. According to judgment standard on healing of fracture, the average time of healing in cases was 5 months （ from 3 to 7 months） , The fineness rate was 95.0%. （~）Compress plate group： the average time during the operation was 1.45 hours, the average amount of bleeding was 200 ml, the average length of incision was 15 cm. One case incisions had superficial infection, 1 case had deep tissue infection and healed after debridement. These cases were allowed to walk by stick after 2 weeks of post-op- erative, there were 2 cases who suffered from nonunion of fracture because of implants loosening were found in the followed-up pe- riod, the average time of healing in cases was 5.2 months （from 4 to 9 months）; The fineness rate was 92.7%. Conclusion The excellent or good outcomes of tibia fracture could be obtained through the operative treatment. The interlocking nail and compression plate have their own advantages in biomechanical properties and clinical effect.
出处
《临床医学》
CAS
2012年第11期5-7,共3页
Clinical Medicine
关键词
髓内钉
钢板
胫骨干骨折
内固定术
效果
Interlocking nail
Compress plate
Tibia shaft fracture
Internal fixation
Effect
