【摘要】 目的观察专家型胫骨交锁髓内钉(ETN)及锁定加压钢板(LCP)在治疗胫骨远端骨折中的疗效。方法选取2012年1月-2015年2月诊治的73例胫骨远端骨折患者,按就诊顺序编号后用随机数字法分为ETN组(n=36)和LCP组(n=37),ETN组给予ETN内固定治疗而LCP组给予LCP内固定,观察两组术前准备时间、手术及住院时间、术中出血量、术后肿胀消退时间、完全负重时间、临床骨折愈合时间,并观察两组术后3、12个月胫骨骨折疗效(Johner-Wruhs)及踝关节评分(Baird-Jackson系统),记录两组术后1年以内并发症发生情况。结果 ETN组术前准备时间(4.2±0.6)d、术中出血量(118.4±22.6)mL、术后肿胀消退时间(4.1±0.6)d,均少于LCP组[(5.1±0.7)d、(147.4±25.2)mL、(6.3±0.7)d];但ETN组手术时间(142.5±21.3)min却多于LCP组(118.9±19.6)min,差异有统计学意义(P<0.05);术后3个月ETN组Baird-Jackson评分[(84.8±5.5)分]及治疗的有效率均高于LCP组[(80.2±5.2)分],且差异具有统计学意义(P<0.05),但术后12个月两组差异无统计学意义(P>0.05);术后1年ETN组并发症发生率5.6%,与LCP组24.3%比较差异有统计学意义(P<0.05)。结论 ETN和LCP治疗胫骨远端骨折各有优劣,但近期疗效ETN优于LCP,治疗时需要根据患者具体情况个体化选择内固定方式。更多还原

【Abstract】 Objective To observe the results of using the locking compression plate( LCP) and the expert tibia nail( ETN) on fractures of distal tibia. Methods Totally 73 cases of distal tibial fractures treated between Jan. 2012 and Feb. 2015 in our hospital,were randomly divided into the ETN group( n = 36) and the LCP group( n = 37). The ETN group received ETN internal fixation and LCP group received LCP internal fixation. The intraoperative and postoperative conditions( including the preparation time,surgery time,hospitalization time,blood volume,swelling reduction time,weight bearing time,and healing time) and curative effect( Johner-Wruhs) of the two groups after 3 and 12 months were analyzed. The incidence of complications within 1 year after operation was observed. Results The time of operation for surgery,the loss volume of blood during operation and postoperative swelling subsided time in the ETN group was( 4. 2 ± 0. 6) d,( 118. 4 ± 22. 6) mL,( 4. 1 ± 0. 6) d,respectively,which were lower than those of the LCP group [( 5. 1 ± 0. 7) d,( 147. 4 ± 25. 2) mL,( 6. 3 ± 0. 7) d]. The operation time or the ETN group was( 142. 5 ± 21. 3) min,which was longer than the LCP group( 118. 9 ± 19. 6) min( P <0. 05). The Johner-Wruhs and Baird-Jackson scores were significantly different between the two groups at 3months after operation [( 84. 8 ± 5. 5) vs.( 80. 2 ± 5. 2),P < 0. 05],but had no difference at 12 months after operation. And the LCP owned a higher rate of postoperative complications than ETN( 24. 3% vs. 5. 6%,P < 0. 05).Conclusion Both methods of internal fixation have advantages and disadvantages,but ETN has better short term results. Fixation should be individually selected based on the condition of the patients.更多还原