【摘要】：目的：通過觀察對比分析交鎖髓內(nèi)釘和加壓鋼板治療脛骨中下段骨折的臨床療效,探討脛骨中下段骨折的治療方案,為臨床治療提供經(jīng)驗(yàn)。材料與方法：選取2013年3月至2014年8月期間,在沈陽市骨科醫(yī)院微創(chuàng)骨科病房住院經(jīng)同一個(gè)醫(yī)生手術(shù)治療的脛骨中下段骨折、AO分型為Bl型的患者42例作為研究對象,按照患者入院順序,隨機(jī)分為交鎖髓內(nèi)釘組(A組)與加壓鋼板組(B組),每組21例。術(shù)后給予患者抗生素靜點(diǎn)預(yù)防感染,脫水藥靜點(diǎn)促進(jìn)消腫,口服利伐沙班預(yù)防下肢深靜脈血栓形成,口服接骨藥促進(jìn)骨折愈合等治療,并指導(dǎo)其功能鍛煉。觀察并記錄兩組手術(shù)時(shí)間、切口長度、術(shù)中出血量、開始負(fù)重時(shí)間、骨折愈合時(shí)間、膝、踝關(guān)節(jié)功能恢復(fù)等,并詳細(xì)記錄獲得的數(shù)據(jù),最后用SPSS17.0統(tǒng)計(jì)軟件對所得數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果：1.兩組患者在性別、年齡、致傷原因、骨折類型、骨折部位方面比較,P0.05,差異無統(tǒng)計(jì)學(xué)意義,具有可比性。2.兩組在手術(shù)時(shí)間、術(shù)中出血量、切口長度、開始負(fù)重時(shí)間及骨折愈合時(shí)間的比較,P0.05,差異有統(tǒng)計(jì)學(xué)意義,表明髓內(nèi)釘組在手術(shù)時(shí)間、術(shù)中出血量、切口長度、開始負(fù)重時(shí)間及骨折愈合時(shí)間等方面優(yōu)于加壓鋼板組。3.兩組術(shù)后在膝、踝關(guān)節(jié)功能恢復(fù)的比較,P0.05,差異有統(tǒng)計(jì)學(xué)意義,表明髓內(nèi)釘組在膝、踩關(guān)節(jié)功能恢復(fù)方面優(yōu)于加壓鋼板組。結(jié)論：1與加壓鋼板治療方法比較,交鎖髓內(nèi)釘具有手術(shù)時(shí)間短、切口小、術(shù)中出血量少、開始負(fù)重時(shí)間短等優(yōu)勢。2.與加壓鋼板治療方法比較,交鎖髓內(nèi)釘具有骨折愈合時(shí)間短的優(yōu)勢。3.與加壓鋼板治療方法比較,交鎖髓內(nèi)釘具有膝、踝關(guān)節(jié)功能恢復(fù)時(shí)間短的優(yōu)勢。
[Abstract]:Objective: to compare and analyze the clinical effect of interlocking intramedullary nail and compression plate in the treatment of middle and lower tibial fractures, and to explore the treatment scheme of middle and lower tibia fractures, and to provide experience for clinical treatment. Materials and methods: from March 2013 to August 2014, 42 patients with middle and lower tibial fractures classified as Bl type in the minimally invasive orthopedic ward of Shenyang Orthopaedics Hospital were selected. According to the order of admission, the patients were randomly divided into interlocking intramedullary nail group (group A) and compression plate group (group B) with 21 cases in each group. After operation, patients were given antibiotics to prevent infection, dehydration drugs to promote detumescence, oral rivastaban to prevent deep venous thrombosis of lower extremity, oral osteosynthesis to promote fracture healing, and to guide their functional exercise. The time of operation, length of incision, amount of blood lost during operation, time of starting load, time of fracture healing, functional recovery of knee and ankle were observed and recorded. Finally, the statistical analysis of the data is carried out with SPSS17.0 software. The result is 1: 1. There was no significant difference in sex, age, cause of injury, fracture type and fracture site between the two groups (P 0.05). There were significant differences between the two groups in operation time, intraoperative bleeding volume, incision length, starting weight loading time and fracture healing time (P 0.05), which indicated that intramedullary nail group had significant difference in operation time, intraoperative bleeding volume and incision length. The loading time and fracture healing time were better than that of compression plate group. 3. The difference of functional recovery of knee and ankle joint between the two groups was statistically significant, which indicated that the functional recovery of knee joint and trampling joint in intramedullary nail group was better than that in compression plate group. Conclusion compared with the treatment of compression plate, the interlocking intramedullary nail has the advantages of short operation time, small incision, less blood loss during operation, and short time of starting weight bearing. Compared with compression plate, interlocking intramedullary nail has the advantage of shorter healing time. Compared with compression plate, interlocking intramedullary nail has advantages of short recovery time of ankle joint and knee joint.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 王為;鉤狀加壓鋼板治療尺骨鷹嘴粉碎骨折[J];中國中西醫(yī)結(jié)合外科雜志;2001年01期

2 覃立勤;何學(xué)泉;;加壓鋼板置于內(nèi)側(cè)治療脛骨骨折50例[J];海南醫(yī)學(xué);2009年04期

3 李光業(yè),邱廣義;應(yīng)用加壓鋼板治療骨折的探討[J];第二軍醫(yī)大學(xué)學(xué)報(bào);1982年03期

4 王忠;;加壓鋼板治療四肢長管狀骨骨折36例總結(jié)[J];寧夏醫(yī)學(xué)雜志;1989年02期

5 胡堪錦,耿介;選擇加壓鋼板的臨床應(yīng)用(附91例報(bào)告)[J];陜西醫(yī)學(xué)雜志;1992年03期

6 陳東安,白孟海,葛寶豐,劉興炎;框式梯形加壓鋼板的研究與臨床應(yīng)用[J];蘭州醫(yī)學(xué)院學(xué)報(bào);1994年03期

7 陳東安，，葛寶豐，劉興炎，陳玉芳;框式梯形加壓鋼板的研究與臨床應(yīng)用[J];中國骨傷;1995年01期

8 黃偉松;角形自身加壓鋼板內(nèi)固定的臨床應(yīng)用[J];中國骨傷;1996年05期

9 田毅;陳軍;劉安元;;鎖定鋼板與加壓鋼板治療肱骨骨折合并橈神經(jīng)損傷的療效比較[J];當(dāng)代醫(yī)學(xué);2014年10期

10 陳鵬濤;王強(qiáng);蔣百川;王驊;王靜成;;齒接觸槽形加壓鋼板的生物力學(xué)實(shí)驗(yàn)研究[J];交通醫(yī)學(xué);2008年03期

相關(guān)會議論文 前4條

1 陳天國;趙正旭;;經(jīng)皮加壓鋼板治療高齡股骨轉(zhuǎn)子間骨折分析[A];2009年浙江省骨科學(xué)學(xué)術(shù)年會論文匯編[C];2009年

2 俞葉鋒;戴加平;;經(jīng)皮加壓鋼板微創(chuàng)治療股骨轉(zhuǎn)子間骨折[A];2009年浙江省骨科學(xué)學(xué)術(shù)年會論文匯編[C];2009年

3 韓偉;田曉濱;李波;邱冰;周焯家;孫立;;旋入式自鎖髓內(nèi)釘與加壓鋼板治療肱骨骨折療效分析[A];2009第一屆貴州骨科論壇論文匯編[C];2009年

4 張雪松;張春才;嚴(yán)望軍;許碩責(zé);王家林;蘇佳燦;;比較加壓鋼板、髓內(nèi)釘及天鵝型記憶接骨器對犬股骨骨折愈合的影響[A];2008年上海市醫(yī)用生物材料研討會論文匯編[C];2008年

相關(guān)碩士學(xué)位論文 前4條

1 康明明;LCP鋼板和加壓鋼板治療脛骨干骨折骨不連的臨床比較[D];山西醫(yī)科大學(xué);2008年

2 莫瑞冰;經(jīng)皮加壓鋼板與股骨近端防旋髓內(nèi)釘治療老年股骨粗隆間骨折的比較性研究[D];遵義醫(yī)學(xué)院;2014年

3 馮旭;交鎖髓內(nèi)釘和加壓鋼板治療脛骨中下段骨折的臨床療效觀察[D];遼寧中醫(yī)藥大學(xué);2015年

4 丁月亭;骨折不愈合的臨床研究及相關(guān)分析[D];山東中醫(yī)藥大學(xué);2008年

本文編號：2139778