摘要
目的回顾性分析胫骨远端干骺端骨折患者采用髓内钉与微创钢板技术治疗的效果。方法选取胫骨远端干骺端骨折患者54例列入研究中,回顾分析所有患者的病历资料,根据治疗方案的不同将其分为两组,即对照组(n=26)和观察组(n=28)。对照组采纳微创钢板技术治疗,观察组采纳髓内钉治疗。对比两组手术及术后恢复指标,术后并发症发生率,血清炎性因子水平,踝关节视觉模拟评分法(VAS)、美国足踝矫形学会(AOFAS)评分,临床治疗效果。结果两组手术时间与术中失血量对比无差异(P>0.05),但观察组住院时间(8.55±1.42)d及骨折愈合时间(17.51±2.01)周短于对照组的(10.61±2.11)d、(19.22±2.45)周(P<0.05)。观察组术后并发症发生率7.1%明显低于对照组的38.5%(P<0.05)。两组术前血清C反应蛋白、降钙素原(PCT)、血沉(ESR)、白细胞介素-6(IL-6)水平对比无差异(P>0.05);两组术后24 h的血清C反应蛋白、PCT、ESR、IL-6水平均高于本组术前,但观察组术后24 h血清C反应蛋白(52.14±10.55)mg/L、ESR(45.21±11.60)mm/h、IL-6(202.11±28.10)ng/L均低于对照组的(62.11±12.55)mg/L、(56.24±13.21)mm/h、(226.75±20.24)ng/L(P<0.05)。两组术前及随访时的踝关节VAS、AOFAS评分对比均无差异(P>0.05);两组随访时的踝关节VAS评分均低于本组术前、AOFAS评分均高于本组术前(P<0.05)。观察组临床治疗总有效率96.4%与对照组的92.3%对比无差异(P>0.05)。结论胫骨远端干骺端骨折治疗中,髓内钉与微创钢板技术均具有一定的治疗效果,但髓内钉可以缩短住院时间与骨折愈合时间,而且还能减少并发症,更有一定的优势。
Objective To retrospectively analyze the effect of intramedullary nail and minimally invasive steel plate techniques in patients with distal tibial metaphyseal fracture.Methods 45 patients with distal tibial metaphyseal fractures were selected for inclusion in the study,and the medical records of all the patients were reviewed and analyzed.They were divided into two groups according to the different treatment plans,namely the control group(n=26)and the observation group(n=28).The control group was treated with minimally invasive steel plate techniques,and the observation group was treated with intramedullary nail.Both groups were compared in terms of surgical and postoperative recovery indexes,incidence of postoperative complications,serum inflammatory factor levels,visual analogue scale(VAS)and American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale(AOFAS)score of the ankle joint,and clinical therapeutic effects.Results There was no difference in operation time and intraoperative blood loss between the two groups(P>0.05).However,the duration of hospitalization in the observation group was(8.55±1.42)d and the fracture healing time was(17.51±2.01)weeks,which were shorter than(10.61±2.11)d and(19.22±2.45)weeks in the control group(P<0.05).The incidence of postoperative complications in the observation group was 7.1%,which was significantly lower than 38.5%in the control group(P<0.05).Before operation,there were no differences in serum C-reactive protein,procalcitonin(PCT),erythrocyte sedimentation rate(ESR)and interleukin-6(IL-6)levels between the two groups(P>0.05).At 24 h after operation,the levels of serum C-reactive protein,PCT,ESR and IL-6 in both groups were higher than those before operation;the observation group had serum C-reactive protein of(52.14±10.55)mg/L,ESR of(45.21±11.60)mm/h,and IL-6 of(202.11±28.10)ng/L,which were lower than(62.11±12.55)mg/L,(56.24±13.21)mm/h,and(226.75±20.24)ng/L in the control group(P<0.05).There were no differences in VAS and AOFAS scores in the ankle joint between the two groups before operation and at follow-up(P>0.05).The ankle VAS score in both groups was lower than that before operation,and the ankle AOFAS score was higher than that before surgery(P<0.05).The total clinical effective rate of the observation group was 96.4%,which had no difference compared with 92.3%in the control group(P>0.05).Conclusion Both intramedullary nails and minimally invasive steel plate techniques have certain therapeutic effects for the treatment of distal tibial metaphyseal fracture.But intramedullary nails can shorten the duration of hospitalization and fracture healing,and it can reduce complications,and has a certain advantage.
作者
王伟
刘丽
WANG Wei;LIU Li(Department of Infection Control,Jinan Seventh People's Hospital,Jinan 250101,China)
出处
《中国实用医药》
2025年第11期39-43,共5页
China Practical Medicine
关键词
胫骨远端干骺端骨折
髓内钉
微创钢板技术
并发症
Distal tibial metaphyseal fracture
Intramedullary nail
Minimally invasive steel plate techniques
Complications
