本文選題：骨折 + 腓骨遠(yuǎn)端�。� 參考：《延安大學(xué)》2015年碩士論文

【摘要】：【背景】腓骨遠(yuǎn)端骨折是常常牽涉關(guān)節(jié)內(nèi)的骨折,在臨床中治療中為了盡量減低患者的創(chuàng)傷性或退行性關(guān)節(jié)炎出現(xiàn)的幾率,則在治療方面常常需要使骨折達(dá)到良好的解剖復(fù)位。術(shù)中是否可以達(dá)到解剖復(fù)位就成為了手術(shù)成功的必要前提及條件。目前對(duì)于腓骨遠(yuǎn)端骨折的手術(shù)治療,切開復(fù)位合并鋼板內(nèi)固定的治療是常用的治療方法,手術(shù)操作對(duì)醫(yī)師的技術(shù)要求不高,雖然術(shù)后會(huì)出現(xiàn)一定的并發(fā)癥,但可在直視下復(fù)位,可使骨折盡量達(dá)到理想的復(fù)位效果。但是,隨著骨折固定理念的變化,髓內(nèi)固定作為腓骨遠(yuǎn)端骨折的另一種方法,由于其手術(shù)要求的切口相對(duì)較小,而且術(shù)后出現(xiàn)并發(fā)癥的幾率也較小,但對(duì)醫(yī)師的操作技術(shù)要求較高,能提供良好的影像學(xué)結(jié)果和功能恢復(fù)。【目的】比較髓內(nèi)釘與鋼板治療腓骨遠(yuǎn)端骨折的臨床差異【方法】分析2012年6月—2014年7月在延安大學(xué)附屬醫(yī)院骨科60例腓骨遠(yuǎn)端骨折分別采用髓內(nèi)釘和鋼板治療比較。其中(A組)34人,(B組)26人,涉及患者的性別、年齡或者骨折的類型方面,在統(tǒng)計(jì)學(xué)研究中均無(wú)意義(P0.05)。比較兩組的切口長(zhǎng)度、出血量、手術(shù)時(shí)間、骨折愈合時(shí)間及踝關(guān)節(jié)功能評(píng)分,并利用SPSS17.0對(duì)研究的所有臨床資料進(jìn)行統(tǒng)計(jì)學(xué)方面的分析并得出結(jié)論�！窘Y(jié)果】所有的患者都進(jìn)行了臨床隨訪并且時(shí)間至少為6個(gè)月。髓內(nèi)釘組的手術(shù)切口長(zhǎng)度、手術(shù)出血量、手術(shù)時(shí)間小于鋼板組,且有統(tǒng)計(jì)學(xué)意義(P0.05)。骨折愈合時(shí)間方面以及術(shù)后6個(gè)月的踝關(guān)節(jié)功能評(píng)分,髓內(nèi)釘組與鋼板組無(wú)明顯差別(P0.05)�！窘Y(jié)論】對(duì)于大多數(shù)的腓骨遠(yuǎn)端骨折,切開復(fù)位鋼板內(nèi)固定仍然是常規(guī)的固定手段,適應(yīng)癥廣,能使腓骨遠(yuǎn)端骨折達(dá)到解剖復(fù)位,且固定可靠,取得良好的功能恢復(fù),臨床操作并不復(fù)雜。髓內(nèi)釘為閉合復(fù)位,操作技術(shù)要求較高,且術(shù)中透視次數(shù)較多,骨折的復(fù)位較鋼板略差。但髓內(nèi)釘組為閉合復(fù)位,軸心固定,更符合生物力學(xué),皮膚切口小,軟組織剝離自然少,術(shù)中出血也較少,骨折斷端處的血運(yùn)得到保護(hù)。但是由于腓骨遠(yuǎn)端本身軟組織覆蓋少,血運(yùn)較差,最終兩組骨折的臨床愈合時(shí)間以及遠(yuǎn)期踝關(guān)節(jié)功能的恢復(fù)無(wú)明顯差異。
[Abstract]:[background] Distal fibula fractures are often associated with intra-articular fractures. In order to minimize the incidence of traumatic or degenerative arthritis in clinical treatment, it is often necessary to achieve good anatomical reduction in the treatment of distal fibula fractures. Whether or not anatomical reduction can be achieved during the operation becomes the necessary prerequisite and condition for the success of the operation. At present, open reduction combined with plate internal fixation is a common treatment for distal fibula fractures. The technical requirements for doctors are not high in the operation. Although there will be certain complications after operation, they can be reduced under direct vision. Can make fracture as far as possible to achieve ideal reduction effect. However, as the concept of fracture fixation changes, intramedullary fixation as another method of distal fibula fracture requires a relatively small incision and a lower incidence of postoperative complications. But the technical requirements for doctors are high. [objective] to compare the clinical differences between intramedullary nail and plate in the treatment of distal fibula fracture [methods] 60 cases of orthopedics in the affiliated Hospital of Yan'an University from June 2012 to July 2014 were analyzed. The distal fibula fractures were treated with intramedullary nail and plate respectively. Among them, 34 patients in group A and 26 patients in group B were involved in sex, age or type of fracture, which had no significance in statistical study. The incision length, bleeding volume, operative time, fracture healing time and ankle function score were compared between the two groups. All clinical data of the study were statistically analyzed and concluded using SPSS17.0. [results] all patients were followed up for at least 6 months. In the intramedullary nail group, the length of incision, the amount of operative bleeding and the operative time were smaller than those in the plate group, and there was significant difference between the two groups (P 0.05). There was no significant difference between the intramedullary nail group and the plate group in the healing time of fracture and the ankle function score 6 months after operation. [conclusion] for most distal fibula fractures, open reduction and plate fixation is still the routine fixation method. The indications are wide, the distal fibula fracture can achieve anatomical reduction, reliable fixation, good functional recovery, and the clinical operation is not complicated. The intramedullary nail is closed reduction, the operation technique is high, and the times of intraoperative fluoroscopy are more, the reduction of fracture is a little worse than that of steel plate. However, the intramedullary nail group is closed reduction, axial fixation, more in line with biomechanics, skin incision small, soft tissue stripping natural less, less intraoperative bleeding, fracture at the end of the blood was protected. However, due to less soft tissue coverage and poor blood circulation, there was no significant difference in the healing time and the long-term recovery of ankle function between the two groups.
【學(xué)位授予單位】：延安大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.3

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相關(guān)期刊論文 前1條

1 翟文亮,劉暉,丁真奇,練克儉,陳文浩;腓骨鋼板內(nèi)固定治療開放性脛腓骨骨折[J];臨床骨科雜志;2003年04期

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本文編號(hào)：1947284