交锁髓内钉固定治疗胫骨骨折临床疗效观察.doc

交锁髓内钉固定治疗胫骨骨折临床疗效观察[摘要] 目的 比较交锁髓内钉固定和外固定架两种方法治疗胫骨骨折的临床疗效。方法 102例胫骨骨折患者随机分为外固定支架组及交锁髓内钉固定组各51例，比较两组的疗效及并发症情况。结果 所有患者术后随访10个月，交锁髓内钉组骨痂出现时间及骨折愈合时间均明显短于外固定支架组，差异有统计学意义（P＜0.01）；两组总有效率比较差异有显著统计学意义（P＜0.01）。外固定支架组并发症发生率24.5%，交锁髓内钉组并发症发生率9.8%，交锁髓内钉组的并发症发生率明显低于外固定支架组（P＜0.05）。结论 交锁髓内钉治疗胫骨骨折在恢复时间和疗效等方面优于外固定支架且较并发症少、安全有效。 [关键词] 胫骨骨折；外固定支架；交锁髓内钉；并发症 [中图分类号] R683.42 [文献标识码] B [文章编号] 1673-9701（2011）26-33-02 Intramedullary Nailing for Tibial Fracture Treatment AN Laiyu CHEN Xinghua LIU Zhiyan ZHENG Sihua Yuhuan County the Second People’s Hospital，Zhejiang Province，Yuhuan 317605，China [Abstract] Objective To compare the clinical effect of intramedullary nailing and external fixation on tibial fractures. Methods All 102 cases of tibial fractures were randomly divided into the external fixator group and intramedullary nailing groups，and the effect and complications were compared. Results All patients were followed up for 10 months，time of occurrence and fracture callus healing time of the intramedullary nail group were significantly shorter than the external fixation group，the difference was statistically significant（P＜0.01）. Total effective rate between two groups had a significant difference （P＜0.05）. External fixator group 24.5% incidence of adverse reactions，intramedullary nail group 9.8%，significantly lower than the external fixation group（P＜0.05）. Conclusion Intramedullary nailing in the treatment of tibial fractures is superior to external fixator in the recovery time and effective rate，and has fewer complications than external fixator，which is a safe and effective method. [Key words] Tibial fractures；External fixation；Intramedullary nail；Complications 胫骨骨折是临床最常见的骨折，髓内固定的方式也被越来越多的临床医生所推崇，尤其是交锁髓内钉固定，由于具有抗旋转性、抗缩短等优点，在临床中的应用较为广泛。我院2007年9月～2009年1月共收治102例胫骨骨折患者，选择102例患者作为研究对象，分别应用交锁髓内钉和外固定架进行治疗，通过术后随访比较两种治疗方法在疗效、并发症等方面的差异，现报道如下。 1 资料与方法 1.1 一般资料 经过医院伦理委员会批准和患者签署知情同意书后，选择2007年9月～2009年1月在我院就诊的102例胫骨骨折患者作为研究对象，按照随机原则分为外固定支架组及交锁髓内钉固定组，每组51例。所有研究对象中男50例，女5