摘要
[目的]比较采用微创技术LCP内固定治疗胫骨远段骨折中切开复位与闭合复位的临床疗效。[方法]回顾性分析2006年5月～2008年8月采用微创技术LCP内固定中切开复位或闭合复位的106例胫骨远段骨折的治疗效果,根据复位方式分成切开复位组(n=50)和闭合复位组(n=56),比较两组的平均手术时间、术中平均X线透视时间、术中出血量、骨折平均愈合时间、切口长度、骨折复位程度、感染率,并采用Johner-Wruhs评分[11]方法评价术后肢体功能,采用五分法评价病人满意程度。[结果]所有患者获得12～27个月(21.2个月)随访,两组患者在手术时间、术中出血量、骨折平均愈合时间、术后功能、感染率方面差异无统计学意义(P>0.05),所有骨折均获得愈合,Johner-Wruhs评分结果优良率均超过90.0%。无感染及皮肤坏死。X线透视时间:切开复位组为2～9 s(平均5.5 s),闭合复位组为8～22 s(平均15.0 s)。平均手术时间:切开复位组为100 min,闭合复位组为106 min。切开复位组透视时间明显短于闭合复位组,平均手术时间前者比后者短,前者具有更好的骨折对位、复位操作相对容易;闭合复位组具有较少的手术出血量,切口长度稍短,患者较易接受。[结论]对于采用微创技术LCP内固定治疗胫骨远段骨折,闭合复位与切开复位均可取得满意疗效,而后者运用微创技术保护骨膜的切开复位可以减少透视时间,复位技术相对简单,对透视设备要求较低。
[ Objective] To compare the clinical efficacy of open reduction with closed reduction in the use of minimally in- vasive techniques LCP internal fixation within the distal tibial fracture. [ Method] The treatment effects of 106 cases of distal tibial fracture retrospectively treated by open reduction or closed reduction in the use of minimally invasive techniques LCP were analyzed. The analysis was according to reduction mode, which was divided into open reduction group （ n = 50） and closed re- duction group （n =56） ,to compare the average operative time, mean intraoperative X-ray fluoroscopy time, bleeding volume, mean fracture healing time, incision length, fracture reduction degree, and infection rate. The analysis employed the introduced Johner-Wrnhs rating method[1~] to evaluate limb function, and 5 scores method to evaluate patient satisfaction. [ Result] All ca- ses were followed up for about 12 to 27 months（ averagely 21.2 months）. The difference in operative time, bleeding volume, mean fracture healing time, postoperative function and infection rate between the two groups was not statistically significant （P 〉 O. 05）. All fractures healed, and the excellent result rates from Johner-Wruhs rating method were all more than 90%, with- out infection and skin necrosis. X-ray fluoroscopy time of open reduction group was 2 -9 seconds （5.5 seconds）, while that of closed reduction group was 8 -22 seconds （15.0 seconds）. The mean operative time of open reduction group was 100 minutes, and that of closed reduction group was 106 minutes. X-ray fluoroscopy time of open reduction group was significantly shorter than that of closed reduction group, and the mean operative time of the former was shorter than that of the latter. The former had better fracture para position, reduction operation was relatively easy, meanwhile the latter had less blood loss, shorter incision length, which were easier accepted by the patients. [ Conclusion] To treat distal tibial fracture by minimally invasive techniques LCP internal fixation, the closed reduction and the open reduction could both achieve satisfactory results, while the latter could protect the open reduction of periosteum to reduce the fluoroscopy time by minimally invasive techniques, of which the reduction techniaue is relatively simple and requires lower fluoroscopy equipments.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2013年第4期338-341,共4页
Orthopedic Journal of China
关键词
胫骨远段骨折
LCP
微创技术
骨折复位
骨折固定术
distal tibial fracture, LCP, minimally invasive techniques, fracture reduction, fracture fixation
