【摘要】：目的:比較可吸收釘板與金屬材料固定治療內(nèi)外踝骨折療效,為內(nèi)外踝骨折患者手術(shù)內(nèi)固定材料的選擇提供依據(jù)。方法:本研究選取我院2013年1月~2014年12月71例內(nèi)外踝骨折患者,這些病例均由同一治療小組收治,將其分成兩組,分別是金屬材料組(Metal materials internal fixation,MIF)和可吸收釘板組(Absorbable nail plate,ANP),其中金屬組36例,材料選用外踝鎖定解剖板和拉力螺釘,MIF組術(shù)中檢查少部分病例內(nèi)固定不夠牢靠,術(shù)后予以石膏外固定6周�？晌蔗敯褰M35例,材料使用可吸收釘板系統(tǒng),ANP組術(shù)后常規(guī)石膏外固定6周。在完整的71例內(nèi)外踝骨折患者中男33例33踝,女38例38踝,左踝36例,右踝35例;年齡20-60歲,平均39.20歲;Weber分型A、B、C型骨折分別為25、29、17例。對(duì)兩組病例的年齡,術(shù)后1、2、3、6、12個(gè)月骨痂最大直徑,術(shù)后1、2、3、6、12個(gè)月X線灰度值和術(shù)后2、3、6、12個(gè)月踝關(guān)節(jié)評(píng)分進(jìn)行比較。結(jié)果:MIF組和ANP組各有一例患者出現(xiàn)輕度創(chuàng)傷性關(guān)節(jié)炎,金屬材料組有一例患者骨折延遲愈合。所有病例均未出現(xiàn)感染。MIF組內(nèi)固定物無松動(dòng)斷裂。兩組病例均無骨不連等并發(fā)癥。兩組病例在年齡、12個(gè)月骨痂最大直徑、12個(gè)月骨痂X線灰度值、3個(gè)月踝關(guān)節(jié)評(píng)分、6個(gè)月踝關(guān)節(jié)評(píng)分、及12個(gè)月踝關(guān)節(jié)評(píng)分方面比較,差異無統(tǒng)計(jì)學(xué)意義;而在1、2、3、6個(gè)月骨痂最大直徑和1、2、3、6個(gè)月骨痂X線灰度值以及2個(gè)月踝關(guān)節(jié)評(píng)分方面比較,差異有統(tǒng)計(jì)學(xué)意義。結(jié)論:結(jié)果顯示,內(nèi)外踝骨折的手術(shù)治療中,可吸收材料可以達(dá)到固定骨折的效果,且在術(shù)后2、3、6個(gè)月時(shí)ANP組的骨痂量比MIF組多,ANP組的骨痂密度比MIF組高,從而反映出在骨痂生長(zhǎng)時(shí)期,ANP組的骨折愈合能力優(yōu)于MIF組,在2、3、6、12個(gè)月踝關(guān)節(jié)功能評(píng)分無差病例,從而反映出可吸收釘板對(duì)踝關(guān)節(jié)的近期與遠(yuǎn)期功能無影響。
[Abstract]:Objective: to compare the efficacy of absorbable nail plate and metal fixation in the treatment of medial and lateral malleolus fractures and to provide evidence for the selection of internal fixation materials for patients with medial and lateral malleolus fractures. Methods: from January 2013 to December 2014, 71 patients with medial and lateral malleolus fractures were treated by the same treatment group and divided into two groups. Metal material group (Metal materials internal fixation,MIF) and absorbable nail plate group (Absorbable nail plate,ANP). Among them, 36 cases of metal group were treated with lateral malleolus locking anatomic plate and pull screw group. The internal fixation was not reliable enough in a few cases during operation, and was treated with plaster external fixation for 6 weeks after operation. The absorbable nail plate group (35 cases) was treated with absorbable nail plate system (ANP) for 6 weeks. Of the 71 patients with medial and lateral malleolus fractures, 33 were males, 38 were females, 36 were left malleolus, and 35 were right malleolus. The age, the maximum callus diameter at 12 months, the X ray gray value at 12 months and the ankle joint score at 12 months were compared between the two groups. Results one case of mild traumatic arthritis was found in the ANP group and one case was delayed union in the metal material group. No loose breakage was found in all cases in the infection. MIF group. There were no nonunion complications in both groups. There was no significant difference in age, maximum callus diameter at 12 months, X-ray gray value of callus in 12 months, ankle joint score at 3 months, ankle joint score at 6 months and ankle joint score at 12 months. There were significant differences in the maximum callus diameter at 6 months, X ray gray value at 6 months and ankle joint score at 2 months. Conclusion: the results showed that absorbable materials could achieve the effect of fixation in the surgical treatment of medial and lateral malleolus fractures, and the callus density of ANP group was higher than that of MIF group at 3 and 6 months after operation. The results showed that the fracture healing ability of the MIF group was better than that of the MIF group during callus growth, and the functional score of the ankle joint was no difference in the second trimester and 12 months, which showed that the absorbable nail plate had no effect on the short-term and long-term function of the ankle joint.
【學(xué)位授予單位】：南昌大學(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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本文編號(hào)：2222985