摘要
目的比较髓内钉内固定术与钢板螺钉内固定术对四肢长管骨创伤骨折的疗效。方法选取南阳市中心医院2023年2月至2024年12月的68例四肢长管骨折患者,随机分为对照组与研究组,每组各34例,对照组行钢板螺钉内固定术,研究组行髓内钉内固定术。比较两组围术期指标、疼痛程度、骨代谢指标、运动功能及并发症。结果两组术中出血量、手术时间比较,差异无统计学意义(P>0.05);研究组骨折愈合时间短于对照组,差异有统计学意义(P<0.05)。术后1周、术后2周,两组视觉模拟评分法(VAS)评分均低于术前1天,且研究组VAS评分均低于同时段对照组,差异有统计学意义(P<0.05)。术后3个月,两组骨钙素(BGP)、骨形态发生蛋白-2(BMP-2)、I型前胶原羧基端肽(PICP)水平均较术前1天升高,且研究组高于对照组,差异有统计学意义(P<0.05)。术后3个月,两组上肢Fugl-Meyer运动功能评定量表(FMA)评分、下肢FMA评分、FMA总分均较术前1天升高,且研究组高于对照组,差异有统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论与钢板螺钉内固定术相比,髓内钉内固定术治疗四肢长管骨折愈合时间更短,术后疼痛更轻,骨代谢与运动功能恢复更快。
Objective To compare the efficacy of intramedullary nail fixation and plate-and-screw internal fixation in the treatment of traumatic fractures of long bones in the extremities.Methods A total of 68 patients with traumatic fractures of long bones in the extremities treated at Nanyang Central Hospital from February 2023 to December 2024 were enrolled and randomly assigned to a control group or a study group(34 cases in each group).The control group underwent plate-and-screw internal fixation.while the study group underwent intramedullary nail fixation.Perioperative indicators.pain severity.bone metabolism markers.motor function.and complications were compared between the two groups.Results There were no statistically significant differences between the two groups in intraoperative blood loss or operative time(P>0.05).The fracture healing time was shorter in the study group than in the control group.with a statistically significant difference(P<0.05).At 1 week and 2 weeks postoperatively.visual analog scale(VAS)scores were lower in both groups than those at 1 day preoperatively;moreover.VAS scores were lower in the study group than in the control group at the corresponding time points.with statistically significant differences(P<0.05).At 3 months postoperatively.levels of osteocalcin(BGP).bone morphogenetic protein-2(BMP-2).and procollagen type I C-terminal propeptide(PICP)were higher in both groups than those at 1 day preoperatively;these levels were higher in the study group than in the control group.with statistically significant differences(P<0.05).At 3 months postoperatively.upper-extremity Fugl–Meyer Assessment(FMA)scores.lower-extremity FMA scores.and total FMA scores were higher in both groups than those at 1 day preoperatively;these scores were higher in the study group than in the control group.with statistically significant differences(P<0.05).There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Compared with plate-and-screw internal fixation.intramedullary nail fixation for traumatic fractures of long bones in the extremities is associated with a shorter fracture healing time.less postoperative pain.and faster recovery of bone metabolism and motor function.
作者
丁远飞
程龙
童磊
DING Yuanfei;CHENG Long;TONG Lei(Department of Trauma Orthopedics,Microsurgery and Hand-and-Foot Surgery,Nanyang Central Hospital,Nanyang Henan 473000,China)
出处
《临床研究》
2026年第2期86-90,共5页
Clinical Research
关键词
四肢长管骨创伤骨折
髓内钉内固定术
钢板螺钉内固定术
疼痛
骨代谢
traumatic fractures of long bones in the extremities
intramedullary nail fixation
plate-and-screw internal fixation
pain
bone metabolism
