摘要
目的探讨Ilizarov外固定技术治疗胫腓骨骨折的临床效果。方法回顾性分析2011年8月-2017年12月收治的胫腓骨骨折患者的临床资料,获得完整随访88例,分为观察组和对照组,各44例。对照组采用Ilizarov外固定技术闭合复位治疗,观察组采用切开复位或微创复位钢板内固定治疗。术后指导患者功能训练。对两组术后治疗情况(包括骨折愈合时间、并发症、关节功能、手术时间、住院时间)进行对比评价。结果观察组骨折均得到愈合,愈合率为100%,中位愈合时间为(3.1±0.8)个月,针道感染2例,神经损伤1例,钢针断裂1例,并发症共4例;对照组骨折愈合38例,愈合率为88.6%,中位愈合时间为(6.8±0.3)个月,感染2例,骨延迟愈合5例,皮肤坏死1例,并发症共8例,参照Johner-Wruhs胫骨干骨折治疗最终效果评价标准评定患肢功能,观察组优于对照组,组间比较差异有统计学意义(P<0.05)。结论应用Ilizarov外固定技术治疗胫腓骨骨折,创伤小、固定牢靠,与钢板内固定相比,可早期负重功能训练,骨折愈合时间短,并发症少,关节功能恢复快,住院时间短,临床效果满意。
Objective To discuss the clinical effect of treating fracture of tibia and fibula by Ilizarov external fixation technique.Methods From August 2011 to December 2017,88 cases with fracture of tibia and fibula were retrospective analyzed,and divided into observation group and control group,44 cases in each group.Ilizarov external fixation technique was applied in control group,and reduction or minimally invasive restoration combining internal fixation with steel plate was applied in observation group.The patients were guided function exercise after operation.The effect after operation was evaluated between two groups,including the time of fracture healing,complication,function of joint,time of operation,hospital stays.Results 44 cases all healed in observation group,the healing rate was 100%,median healing time was(3.1±0.8)months.And there was needle passage infection in 2 cases,nerve injury in 1 case,draw point broken in 1 case,and complication in 4 cases.38 cases healed in control group,healing rate was 88.6%,median healing time was(6.8±0.3)months.And there was infection in 2 cases,fracture delayed union in 5 cases,cutaneous necrosis in 1 case and complication in 8 cases.According to Johner-Wruhs evaluation criterion for fracture of shaft of tibia,the function of injured limb in observation was superior to control group,there was statistic difference between two groups(P<0.05).Conclusion The Ilizarcv external fixation technique for treating tibia and fibula fracture is small trauma and reliable.Comparing with steel plate internal fixation,it has many advantages,such as weight function exercise,shortly healing time,few complication,good joint function,and can obtain satisfactory clinical effect.
作者
申守仁
明新武
明新月
董海亮
常彩虹
刘成瑞
明立功
SHEN Shouren;MING Xinwu;MING Xinyue(Department of Orthopedics,The Orthopedic Hospital of Hua county,Henan Hua county,456485 China)
出处
《实用手外科杂志》
2020年第2期211-213,216,共4页
Journal of Practical Hand Surgery
关键词
Ilizarov外固定技术
胫腓骨骨折
内固定
Ilizarov external fixation technique
Fracture of tibia and fibula
Internal fixation
