摘要
目的:分析闭合复位交锁髓内钉内固定联合阻挡钉在胫骨远端干骺端骨折患者中的应用效果。方法:回顾性分析2023年6月—2024年5月延安市人民医院骨科接收的65例胫骨远端干骺端骨折患者的资料,按固定方法分为髓内钉组(闭合复位交锁髓内钉内固定,32例)、联合组(闭合复位交锁髓内钉内固定联合阻挡钉,33例)。比较两组围术期指标、并发症、免疫功能、骨折复位及愈合情况。结果:联合组骨折愈合时间短于髓内钉组(P=0.036)。两组手术时间、术中出血量、并发症总发生率、骨折复位总优良率比较,无统计学差异(P>0.05)。术前及术后3 d,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平比较,无统计学差异(P>0.05)。联合组骨折愈合总优良率高于髓内钉组(P=0.034)。结论:闭合复位交锁髓内钉内固定联合阻挡钉技术治疗胫骨远端干骺端骨折的效果较好,可促进骨折愈合,且不增加手术创伤及免疫抑制风险。
Objective:To analyze the application effect of closed reduction and interlocking intramedullary nail internal fixation combined with blocking screw in patients with distal tibial metaphyseal fractures.Methods:The data of 65 patients with distal tibial metaphyseal fractures admitted to Orthopedics Department at Yan'an People's Hospital from June 2023 to May 2024 were retrospectively analyzed.According to fixation methods,the above patients were divided into intramedullary nail group(closed reduction and interlocking intramedullary nail internal fixation,32 cases)and combined group(closed reduction and interlocking intramedullary nail internal fixation combined with blocking screw,33 cases).The perioperative indicators,complications,immune function,fracture reduction and healing status were compared between the two groups.Results:The fracture healing time in combined group was shorter than that in intramedullary nail group(P=0.036).The surgical time,intraoperative blood loss,total incidence of complications and overall excellent and good rate of fracture reduction revealed no significant differences between two groups(P>0.05).Before surgery and on 3 d after surgery,there were no statistical differences in the CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)levels between two groups(P>0.05).The overall excellent and good rate of fracture healing in combined group was higher than that in intramedullary nail group(P=0.034).Conclusion:Closed reduction and interlocking intramedullary nail internal fixation combined with blocking screw technique has a better effect in the treatment of distal tibial metaphyseal fractures,and can promote the fracture healing,and will not increase the surgical trauma and immunosuppression risk.
作者
贺永祥
周艳梅
张生
贺统
贺世集
He Yongxiang;Zhou Yanmei;Zhang Sheng;He Tong;He Shiji(Orthopedics Department,Yan'an People's Hospital,Yan'an 716000,Shaanxi Province,China;Rehabilitation Department,Yan'an People's Hospital,Yan'an 716000,Shaanxi Province,China)
出处
《中外医药研究》
2025年第21期35-37,共3页
JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH
基金
延安市重点研发计划项目(编号:2023SLSFGG-123)。
关键词
胫骨远端干骺端骨折
闭合复位
交锁髓内钉
阻挡钉
免疫功能
骨折复位
骨折愈合
Distal tibial metaphyseal fractures
Closed reduction
Interlocking intramedullary nail
Blocking screw
Immune function
Fracture reduction
Fracture healing
