【摘要】 目的 研究切开复位内固定治疗跖跗关节复合体(TJC)损伤的临床效果。方法 40例TJC损伤患者,将其按照内固定材料的不同分成空心钉组以及非空心钉组,每组20例。两组均接受切开复位内固定治疗,空心钉组植入材料选用空心螺钉,非空心钉组植入材料选用普通螺钉、克氏针或微型钢板。比较两组临床疗效、各项手术指标(手术时间、术中失血量、术后住院天数)、术后复位丢失率、骨折愈合时间、下地负重时间、术后并发症发生情况。结果 空心钉组治疗优良率100.00%高于非空心钉组的75.00%,差异具有统计学意义(P<0.05)。空心钉组术后住院天数(9.74±1.25)d短于非空心钉组的(12.98±2.08)d,术中失血量(14.28±2.11)ml少于非空心钉组的(30.95±4.07)ml,差异具有统计学意义(P<0.05)。空心钉组术后复位丢失率0低于非空心钉组的20.00%,骨折愈合时间(12.11±3.24)周、下地负重时间(9.30±2.11)周均短于非空心钉组的(14.75±3.90)、(11.24±2.74)周,差异具有统计学意义(P<0.05)。空心钉组术后并发症发生率5.00%低于非空心钉组的30.00%,差异具有统计学意义(P<0.05)。结论 空心螺钉切开复位内固定治疗TJC损伤的临床疗效显著,且能有效促进患者术后早日康复,缩短术后下地负重时间,减少术后并发症的发生。更多还原

【Abstract】 Objective To study the clinical effect of open reduction and internal fixation for the treatment of tarsometatarsal joint complex(TJC). Methods A total of 40 patients with TJC injury were selected, and were divided into hollow screw group and non-hollow screw group according to the difference of internal fixation materials, with 20 patients in each group. All subjects received open reduction and internal fixation. The hollow screw group was implanted with hollow screws, and the non-hollow screw group was implanted with plain screws,Kirschner wire, or microplates. Both groups were compared in terms of clinical efficacy, operation indexes(operation time, intraoperative blood loss, postoperative hospitalization days), postoperative reduction loss rate, fracture healing time, ground loading time, and postoperative complications. Results The excellent rate of treatment in the hollow screw group was 100.00%, which was higher than 75.00% in the non-hollow screw group, and the difference was statistically significant(P<0.05). The hollow screw group had shorter postoperative hospitalization days of(9.74±1.25) d than(12.98±2.08) d in the non-hollow screw group, and less intraoperative blood loss of(14.28±2.11) ml than(30.95±4.07) ml in the non-hollow screw group. The difference was statistically significant(P<0.05). The hollow screw group had lower postoperative loss rate of reduction of 0 than 20.00% in the non-hollow screw group; in the hollow screw group, the fracture healing time was(12.11±3.24) weeks and the ground loading time was(9.30±2.11) weeks, which were shorter than(14.75±3.90) and(11.24±2.74) weeks in the non-hollow screw group; the difference was statistically significant(P<0.05). The incidence of postoperative complications in the hollow screw group was 5.00%, which was lower than 30.00% in the non-hollow screw group,and the difference was statistically significant(P<0.05). Conclusion Open reduction and internal fixation with hollow screw has significant clinical efficacy in the treatment of TJC injury, and can effectively promote the early postoperative recovery of patients, shorten the postoperative ground loading time and reduce the occurrence of postoperative complications.更多还原