探討脛腓骨骨折手術(shù)治療的臨床療效

[摘要] 目的 探討手術(shù)治療脛腓骨骨折的臨床效果。方法 方便選取2011年10月—2015年10月在該院接受手術(shù)治療的脛腓骨骨折患者180例，并根據(jù)患者不同的手術(shù)方式分為3組，帶鎖髓內(nèi)釘組60例，給予帶鎖髓內(nèi)釘固定手術(shù)；加壓鋼板組60例，給予加壓鋼板內(nèi)固定手術(shù)；外固定支架組60例，給予外固定架手術(shù)，并觀察3組患者術(shù)后骨折愈合時(shí)間、優(yōu)良率、感染率及并發(fā)癥率等臨床療效。結(jié)果 3組患者術(shù)后隨訪結(jié)果顯示，帶鎖髓內(nèi)釘組優(yōu)良率93.33%，加壓鋼板組優(yōu)良率76.67%，外固定支架組優(yōu)良率86.67%，帶鎖髓內(nèi)釘組優(yōu)良率分別與其他兩組比較，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；帶鎖髓內(nèi)釘組、外固定支架組及加壓鋼板組患者骨折愈合時(shí)間分別為（123.5±14.4）d、（155.4±16.2）d、（185.3±15.5）d，3組患者骨折愈合時(shí)間比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05），且?guī)фi髓內(nèi)釘組患者發(fā)生感染率及并發(fā)癥較少。結(jié)論 根據(jù)患者骨折類(lèi)型選擇不同的手術(shù)固定方式，建議首選帶鎖髓內(nèi)釘固定和外固定支架固定，其中帶鎖髓內(nèi)釘組臨床效果顯著，且感染率及并發(fā)癥率較低，值得臨床推廣應(yīng)用。

[關(guān)鍵詞] 脛腓骨骨折；手術(shù)治療；臨床療效

[中圖分類(lèi)號(hào)] R5 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-0742（2016）10（b）-0054-03

[Abstract] Objective To observe the surgical treatment of fractures of the tibia and fibula of the clinical effect. Methods Convenient selection October 2011 tibia and fibula fracture in October 2015 in our hospital 180 cases underwent surgery， and divided into three groups of interlocking intramedullary nail group of 60 patients based on patients with different surgical methods， to give a lock intramedullary nail fixation； compression plate group of 60 patients received compression plate internal fixation； external fixation group， 60 patients received external fixation surgery and 3 groups of patients and observe the clinical efficacy of postoperative fracture healing time， good rate， infection rate and complication rate. Results The patients were followed up for 3 showed， interlocking intramedullary nail group good rate of 93.33%， excellent rate of compression plate group76.67%， external fixation group good rate of 86.67%， interlocking intramedullary nail group good rate， respectively the other two groups， the difference was statistically significant （P<0.05）； Interlocking intramedullary nail group， external fixation group and the group of patients with compression plate fracture healing time was （123.5±14.4）d，（155.4±16.2）d，（185.3±15.5）d， 3 patients fracture healing time the difference was statistically significant （P<0.05）， and the interlocking intramedullary nail group of patients with less infection and complications. Conclusion According to the patient to select a different type of fracture fixation way， suggested that the preferred interlocking intramedullary nailing and external fixation， in which the interlocking intramedullary nail group significant clinical effect， with low rates of infection and complications， is worthy of application.

[Key words] Tibia and fibula fracture； Surgical treatment； Clinical efficacy

脛腓骨骨折在下肢骨折最常見(jiàn)，特別是脛腓骨中下段骨折。由于脛腓骨淺居皮下，周?chē)浗M織不多，血液循環(huán)差，如果手術(shù)治療方式不對(duì)，容易導(dǎo)致骨折延遲愈合或者出現(xiàn)骨折不愈合，甚至引發(fā)感染，嚴(yán)重可致骨髓炎，使治療復(fù)雜化，嚴(yán)重影響患者的生活質(zhì)量[1]。因此，選擇合理的手術(shù)固定方式治療脛腓骨骨折至關(guān)重要。……