內(nèi)固定與外固定治療脛骨遠(yuǎn)端骨折的臨床療效
發(fā)布時(shí)間：2018-07-20 19:15
【摘要】：目的：通過對脛骨遠(yuǎn)端骨折患者分別采用切開復(fù)位內(nèi)固定術(shù)或外固定架術(shù)的治療患者,比較兩種手術(shù)方式在臨床的適應(yīng)癥和療效。方法：回顧性分析2012年1月份至2014年3月份經(jīng)新疆醫(yī)科大學(xué)第一附屬醫(yī)院骨科中心通過手術(shù)治療脛骨遠(yuǎn)端骨折病例176例,有完整定期隨訪記錄53例,年齡≥50歲,并將分別分成切開復(fù)位內(nèi)固定組以及外固定架組,切開復(fù)位內(nèi)固定組31例(男性：17例,女性：14例)；外固定架組：22例(男性：14例,女性：8例),術(shù)后比較兩組的手術(shù)時(shí)間、骨折愈合時(shí)間、踝關(guān)節(jié)功能恢復(fù)時(shí)間、術(shù)后發(fā)生感染并發(fā)癥,參照AOFAS (American Orthopaedic Foot and Ankle Society)評分標(biāo)準(zhǔn)評價(jià)踝關(guān)節(jié)功能及術(shù)AOFAS后的優(yōu)良率。結(jié)果：采用spssl7.0統(tǒng)計(jì)學(xué)分析處理術(shù)后定期隨訪將所符合納入標(biāo)準(zhǔn)條件的53例病歷。(1)內(nèi)固定組與外固定組在手術(shù)時(shí)間比較,兩組數(shù)據(jù)通過t檢驗(yàn),t=11.282,P值=0.0001,兩組差異有統(tǒng)計(jì)學(xué)意義：骨折臨床愈合時(shí)間兩組數(shù)據(jù)通過t檢驗(yàn),t=2.524,P值=0.015,兩組差異有統(tǒng)計(jì)學(xué)意義；恢復(fù)工作崗位時(shí)間(周)兩組數(shù)據(jù)通過t檢驗(yàn),t=-3.756,P值=0.0001,兩組差異有統(tǒng)計(jì)學(xué)意義。外固定架組較內(nèi)固定組手術(shù)操作時(shí)間少,骨折臨床愈合時(shí)間短；內(nèi)固定組比外固定架組恢復(fù)工作時(shí)間較快。(2)兩組在術(shù)后感染并發(fā)癥上通過連續(xù)性校正后,即校正的χ2=0.785,P值=0.376,兩組數(shù)據(jù)無明顯統(tǒng)計(jì)學(xué)差異；兩組在術(shù)后AOFAS評分上數(shù)據(jù)通過t檢驗(yàn),t=1.136,P值=0.261,兩組數(shù)據(jù)無明顯統(tǒng)計(jì)學(xué)差異；以及在兩組患者術(shù)后優(yōu)良率方面比較,數(shù)據(jù)通過卡方檢驗(yàn),χ20.0001,P值=1.000,兩組患者術(shù)后優(yōu)良率無明顯統(tǒng)計(jì)學(xué)差異。結(jié)論：臨床回顧性分析得出,在對于治療脛骨遠(yuǎn)端骨折程度較為嚴(yán)重的患者以及對于涉及踝關(guān)節(jié)面的干骺端作為外固定架可更為安全有效,但切開復(fù)位內(nèi)固定對治療低能量創(chuàng)傷造成的骨折可作為優(yōu)先治療方案。
[Abstract]:Objective: to compare the clinical indications and effects of open reduction and internal fixation or external fixation in patients with distal tibial fractures. Methods: from January 2012 to March 2014, 176 cases of distal tibial fractures were treated by the Orthopaedic Center of the first affiliated Hospital of Xinjiang Medical University. They were divided into open reduction and internal fixation group and external fixator group respectively. There were 31 cases (male: 17, female: 14) in open reduction and internal fixation group, 22 cases (male: 14) in external fixator group. The operative time, fracture healing time, ankle function recovery time and postoperative infection complications were compared between the two groups. The ankle function and the excellent and good rate after operation were evaluated according to the American Orthopaedic foot and Ankle Society (AOFAS). There was significant difference between the two groups by t test (t test 11.282 P = 0.0001): the clinical healing time of fracture in two groups passed t test (t test) and the P value of two groups was 0.015, there was significant difference between the two groups. The recovery time (weekly) of the two groups was 0.0001 by t test (P = 0.0001), and the difference between the two groups was statistically significant. The operation time of the external fixation group was less than that of the internal fixation group, and the time of fracture healing was shorter, and the working time of the internal fixation group was faster than that of the external fixator group. (2) after continuous correction of postoperative infection complications, the operation time of the external fixator group was shorter than that of the internal fixation group. That is to say, the corrected 蠂 2 / 0.785P value was 0.376.There was no significant difference between the two groups in terms of postoperative AOFAS score, and there was no significant difference between the two groups in terms of the excellent and good rate of the two groups, and the difference was not significant between the two groups in terms of the score of AOFAS after operation by t-test (t test), the P value of the two groups was 0.261, and there was no significant difference between the two groups in terms of excellent and good rate. The results of chi-square test showed that the P value of 蠂 20.0001 was 1.000. There was no significant difference in the excellent and good rate between the two groups. Conclusion: the clinical retrospective analysis shows that it is more safe and effective to treat the patients with severe distal tibial fracture and the metaphysis of ankle joint as external fixator. But open reduction and internal fixation can be used as the first treatment for fracture caused by low-energy trauma.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3
，
本文編號：2134496
[Abstract]:Objective: to compare the clinical indications and effects of open reduction and internal fixation or external fixation in patients with distal tibial fractures. Methods: from January 2012 to March 2014, 176 cases of distal tibial fractures were treated by the Orthopaedic Center of the first affiliated Hospital of Xinjiang Medical University. They were divided into open reduction and internal fixation group and external fixator group respectively. There were 31 cases (male: 17, female: 14) in open reduction and internal fixation group, 22 cases (male: 14) in external fixator group. The operative time, fracture healing time, ankle function recovery time and postoperative infection complications were compared between the two groups. The ankle function and the excellent and good rate after operation were evaluated according to the American Orthopaedic foot and Ankle Society (AOFAS). There was significant difference between the two groups by t test (t test 11.282 P = 0.0001): the clinical healing time of fracture in two groups passed t test (t test) and the P value of two groups was 0.015, there was significant difference between the two groups. The recovery time (weekly) of the two groups was 0.0001 by t test (P = 0.0001), and the difference between the two groups was statistically significant. The operation time of the external fixation group was less than that of the internal fixation group, and the time of fracture healing was shorter, and the working time of the internal fixation group was faster than that of the external fixator group. (2) after continuous correction of postoperative infection complications, the operation time of the external fixator group was shorter than that of the internal fixation group. That is to say, the corrected 蠂 2 / 0.785P value was 0.376.There was no significant difference between the two groups in terms of postoperative AOFAS score, and there was no significant difference between the two groups in terms of the excellent and good rate of the two groups, and the difference was not significant between the two groups in terms of the score of AOFAS after operation by t-test (t test), the P value of the two groups was 0.261, and there was no significant difference between the two groups in terms of excellent and good rate. The results of chi-square test showed that the P value of 蠂 20.0001 was 1.000. There was no significant difference in the excellent and good rate between the two groups. Conclusion: the clinical retrospective analysis shows that it is more safe and effective to treat the patients with severe distal tibial fracture and the metaphysis of ankle joint as external fixator. But open reduction and internal fixation can be used as the first treatment for fracture caused by low-energy trauma.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3
，
本文編號：2134496
本文鏈接：http://sikaile.net/yixuelunwen/waikelunwen/2134496.html
最近更新
教材專著
