髓内钉与钢板内固定治疗胫骨远端关节外骨折的比较研究

魏东，何健涛，吴远征

（陕西省礼泉县中医医院外科，陕西 咸阳，713200）

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摘要：

目的 比较并分析髓内钉和钢板内固定对胫骨远端关节外骨折患者进行治疗的临床效果。方法 选择我院在2013年3月至2015年12月收治的120例胫骨远端关节外骨折患者作为研究对象，将所有患者按照随机方法分为Ⅰ组和Ⅱ组，每组 60例，Ⅰ组患者选择髓内钉方法进行治疗，Ⅱ组患者选择钢板内固定方法进行治疗，对两组患者的治疗情况进行观察和比 较。结果 两组患者的手术时间、术后踝关节功能优良率及骨折愈合时间比较，差异无统计学意义（P>0.05）；Ⅰ组患者治疗后的畸形愈合率略低于Ⅱ组，差异有统计学意义（P<0.05），两组患者的延迟愈合率比较，差异不具有统计学意义（P>0.05）。结论 髓内钉治疗和钢板内固定都可以对胫骨远端关节外骨折患者的治疗起到较好的效果，具体方式需要根据患者的实际情况来进行选择。

关键词：髓内钉；钢板内固定；胫骨远端关节外骨折

中图分类号：髓内钉；钢板内固定；胫骨远端关节外骨折文献标志码：A文章编号：2096-1413(2017)22-0089-02

Comparative study of intramedullary nail and plate internal fixation in the treatment of distal tibial lateral fractures
WEI Dong, HE Jian-tao, WU Yuan-zheng
（Department of Surgery, Traditional Chinese Medicine Hospital of Liquan County, Xianyang 713200, China）

ABSTRACT: Objective To compare and analyze the clinical treatment effects of intramedullary nail and plate internal fixation on distal tibial lateral fractures. Methods One hundred and twenty cases of patients with distal tibial lateral fractures admitted in our hospital from March 2013 to December 2015 were selected as the objects, all the patients were randomly divided into group Ⅰ and group Ⅱ , with 60 patients in each group. Group Ⅰwas given intramedullary nail treatment, group Ⅱ accepted plate internal fixation method for treatment. The clinical situations of the two groups were observed and compared. Results There was no significant difference in operation time, excellent rate of ankle function and time of fracture healing between group I and group II (P<0.05). The incidence rate of malformation healing rate in group Ⅰ were significantly lower than those in group Ⅱ , the differences were statistically significant (P<0.05). There was also no statistically significant difference in the incidence rate of delayed healing between the two groups (P>0.05). Conclusion Both of intramedullary nail treatment and internal fixation of the plate have good effects in patients with distal tibial fractures, it need to choose a specific way based on the actual situation of the patients.
KEYWORDS: intramedullary nail; plate internal fixation; distal tibial lateral fratures

参考文献：
[1] 任志强,焦文学,王振昊.锁定髓内钉与钢板内固定治疗胫骨远端骨折的疗效观察[J].临床合理用药杂志,2014,5(30):1542-1543.
[2] 王磊,陈根元,王凤凤,等.扩髓与非扩髓髓内钉置入固定治疗成人闭合性胫骨干骨折的Meta 分析[J].中国组织工程研究,2014,16(17):2031-2033.
[3] 李乾明,周家钤,赵宏谋,等.髓内钉与钢板内固定治疗胫骨远端关节外骨折的比较研究[J].中国骨与关节损伤杂志,2014,27(4):245-246.


[4] 李国胜,胡永成.经皮微创锁定加压钢板置入内固定治疗新鲜胫骨远端骨折32例[J].中国组织工程研究与临床康复,2014,15(13):543-545.


[5] 黄鹏,唐佩福,姚琦,等.胫骨干骨折带锁髓内钉固定和钢板螺钉固定的对比研究[J].中国骨伤,2016,2(4):416-417.
[6] 罗杰.60 例带锁髓内钉与普通钢板螺钉内固定治疗胫骨骨折效果比较[J].现代医药卫生,2016,22(8):193-194.
[7] 方国华,曾青东,孙新,等.带锁髓内钉与加压钢板治疗开放性胫腓骨骨折的比较[J].中国矫形外科杂志,2014,11(2):654-656.
[8] 李海波,刘文全,伍星.胫骨开放骨折加压钢板与带锁髓内钉治疗比较[J].四川医学,2014,22(12):413-416.
[9] 孔闪闪.微创经皮钢板固定术与交锁髓内钉治疗胫骨远端关节外骨折的疗效分析[J].医学理论与实践,2016,29(7):582-583.
[10] 肖向阳.微创接骨板与传统方法治疗胫骨远端关节外骨折疗效对比[J].当代医学,2014,21(33):235-237.
[11] 李建刚,王磊,董喆,等.髓内钉与钢板内固定治疗胫骨远端关节外骨折的Meta分析[J].中国组织工程研究,2013,17(48):8361-8367.