摘要
目的观察胫骨干骨折闭合复位髓内钉固定术后早期踝前疼痛的发生率,分析相关并发症的发生原因。方法对307例胫骨干骨折采用闭合复位、交锁髓内钉固定术治疗,观察早期踝前痛的发生率、VAS疼痛评分和早期踝前疼痛的平均持续时间等,分别于术后即刻、3个月、1年进行踝关节功能评分。结果 39例术后早期发生踝前疼痛,发生率为12.7%,平均持续时间(6.2±3.4)d;静息状态VAS疼痛评分平均(3.1±1.5)分,功能锻炼时VAS疼痛评分平均(4.0±0.9)分,两组比较差异有统计学意义(P<0.05);术后即刻、术后3个月及术后1年AOFAS踝关节功能评分差异无统计学意义(P>0.05)。结论早期踝前疼痛是胫骨干骨折闭合复位、交锁髓内钉固定术后的并发症之一,与远端锁钉的置钉方式及扩髓有一定相关性;踝前疼痛会增加术后功能锻炼时VAS疼痛评分,但对踝关节功能没有显著影响。
Objective To observe the incidence rate of early anterior ankle pain after the therapy of tibial shaft fracture by closed reduction and intramedullary nail fixation method and to analyze the reason of occurrence of related complications. Methods All of 307 patients with tibial shaft fracture were treated by closed reduction and intramedullary nail fixation method. The incidence rate and the average duration of early anterior ankle pain, VAS score and ankle function score was recorded after operation and during 3 and 12 months＂ follow up. Results Thirty nine cases had the anterior ankle pain at early stage after operation and the incidence rate was 12.7%. The average duration of early anterior ankle pain was （6.2±3.4）d. VAS score in resting state was （3.1±1.5） and in functional exercise state was （4.0±0.9）. There were significant differences in the VAS score of two states（P 〈0.05）. But there were no significant differences in ankle function score after operation and during 3 and 12 months＂ follow up. Conclusion Early anterior ankle pain is one of the complications in treating tibial shaft fracture by closed reduction and intrameduUary nail f＇rxation method. The incidence rate is related to the way of distal interlocking screw placement and intraoperative reaming. Early anterior ankle pain can increase the VAS score in functional exercise stage but has no significant effect on the ankle function.
出处
《中国骨与关节损伤杂志》
2013年第6期528-530,共3页
Chinese Journal of Bone and Joint Injury
关键词
胫骨干骨折
髓内钉
内固定
踝前疼痛
早期
Tibial shaft fracture
Intramedullary nail
Internal fixation
Anterior ankle pain
Early
