髓内钉治疗胫骨骨折的疗效观察

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1、髓内钉治疗胫骨骨折的疗效观苗杰江苏省宜兴市第二人民医院214221目的观察髓内钉治疗胫骨骨折的临床疗效。方法选择宜兴市第二人民医院骨科收治的胫骨中下段骨折患者40例，随机分为观察组和对照组两组，每组20例。均采用交锁髓内钉治疗,观察组X片检查见骨折线间隙时去掉远端锁钉，对照组持续静力化直至完全愈合。观察和比较两组患者的骨折愈合时间、踝关节、膝关节疼痛评分和关节功能恢复情况。结果观察组随访2、3、6个月骨折愈合率(50%、90%、100%)明显优于对照组(20%、60%、80%),差异有统计学意义(P&

2、lt;0.05)。术后6个月观察组膝关节VAS评分和疼痛率与对照组比较，差异均无统计学意义(P>0.05);对照组踝关节VAS评分和疼痛率高于观察组，差异有统计学意义(P<0.05);两组膝、踝关节功能评分比较，差异无统计学意义(P>0.05)。结论胫骨中下段骨折采用髓内钉内固定后适时动力化治疗，能有效提高骨愈合率，降低踝关节疼痛的发生率，而不影响关节功能，值得临床推广。【关键词】髓内钉；腔骨骨折；动力化；静力化Abstract:ObjectiveToobservetheclinic

3、aleffectofthetreatmentoftibialfractureswithintramedullarynailing.MethodsChooseSecondPeople'sHospitalofYixingCity,40casesofmiddleanddistaltibialfractureswererandomlydividedintoobservationgroupandcontrolgroup,twocasesineachgroup,20cases.Xtabletsintheobser

4、vationgroupweretreatedwithinterlockingintramedullarynailing,andthedistallockingscrewswereremovedfromthe2mm,andthecontrolgroupwascontinueduntilcompletehealing.Thefracturehealingtime,anklejoint,kneepainscoreandjointfunctionrecoveryofthetwogroupswereobserv

5、edandcompared.ResultsThefracturehealingrate(50%,90%,100%)intheobservationgroupwassignificantlybetterthanthatinthecontrolgroup(20%,60%,80%),andthedifferencewasstatisticallysignificant(P<0.05).TheVASscoreandpainscoreofkneejointintheobservationgroupwere

6、comparedwiththatofthecontrolgroupat6monthsafteroperation,andthedifferencewasnotstatisticallysignificant(P<0.05).lnthecontrolgroup,theVASscoreandpainintheanklejointwashigherthanthatintheobservationgroup,thedifferencewasstatisticallysignificant(P<0.

7、05).Twogroupsofkneeandanklejointfunctionscorecomparison,thedifferencewasnotstatisticallysignificant(P>0.05).ConclusionThetreatmentofposteriortibialfractureswithintramedullarynailing,whichcaneffectivelyimprovetherateofbonehealing,andreducetheincidence

8、ofanklepain,butdoesnotaffectthejointfunction,itisworthyofclinicalpromotion.Keywords:Intramedullarynail;Tibialfracture;Dynamic;StaticR473A2096-0867(2015)-08-046-02胫骨中下1/3骨折常愈合不良，导致延迟愈合或骨不连，是创伤骨科的研究热点之一。自从20世纪70年代出现交锁髓内钉技术以来，髓内钉成为治