摘要
目的比较微创钢板与传统钢板内固定治疗胫骨骨折的临床疗效。方法采用前瞻性研究,将1998年1月至2005年3月收治的60例胫骨骨折随机分为两组,两组条件均衡。其中一组采用微创切开复位限制性接触钢板内固定术(微创组);另一组按传统的AO操作原则行切开复位内固定术(传统组)。对两组的手术时间及结果进行比较。结果全部病例随访12-18个月,平均14个月。微创钢板内固定治疗胫骨骨折组与传统切开组比较,手术时间微创组1.5 h,传统组1.2 h,差异比较无显著性意义(P>0.05)。术后吸收热时间微创组3.3 d,传统组为5.3 d,差异比较有显著性意义(P<0.01)。骨折愈合时间微创组10.1周,传统组13.2周,差异比较有显著性意义(P<0.01)。微创组无延迟愈合病例,传统组有5例延迟愈合,差异比较有显著性意义(P<0.05)。两组均无不愈合病例。结论微创钢板内固定治疗胫骨骨折,手术操作简单、安全、不进一步加重骨膜软组织损伤、骨折愈合快、无延迟愈合和不愈合病例,符合微创生物学内固定观点。
Objective To evaluate the effect of minimally invisave plate osteosynthesis for fractures of tibia and compare it with that of traditional plate osteosynthesis. Methods From January 1998 to March 2005, 60 patients with tibial fracture were randomly assigned into minimally invasive group and traditional group. The age,sex, fracture types and soft tissue condition of the patients in both groups were basically matched and balanced. The patients in one group were treated with minimally invasive plate internal fixation （minimally invasive group）, while the patients in traditional group were treated with traditional open reduction and internal fixation according to AO principles （traditional group）. Compare the time and results of operations in two groups. Results All patients were followed up from 12 to 18 months with an average of 14 months. The operative time was 1.5 h in minimally invasive group and 1.2 h in traditional group respectively, and there was no significant statistical difference（P〉0. 05）. The postoperative fever of the patients in minimally invasive group subsided 3. 3 d and 5.3 d in traditional group. The clinical healing time of the fractures in minimally invasive group were 10. 1 w and 13.2 w in traditional group, there was significant statistical difference between minimally invasive group and traditional group （3.8,P〈0. 01）. No delayed union happened in minimally invasive group, 5 cases of delayed union in traditional group and no nonunion occurred in both groups, there was significant statistical difference（x^2=5. 61, P〈0. 05）. Conclusion Minimally invasive plate osteosynthesis for fractures of tibia is described as simple and safe. There is no further injury in periosteum soft tissue, and no delayed union or nounion cases. It meets minimally invasive biological perspective.
出处
《实用骨科杂志》
2007年第2期72-74,共3页
Journal of Practical Orthopaedics
关键词
胫骨骨折
骨折内固定术
前瞻性研究
微创
tibial fractures
fracture fixation
prospective studies
minimal invasion
