Zhang Hong, Ye Cha-Hua, Yu Hu, Yang Xu-Song
Department of Orthopaedics, the Second People's Hospital of Tongxiang,Tongxiang 314511, Zhejiang, China.
Zhongguo Gu Shang. 2012 Mar;25(3):198-201.
To compare the therapeutic effects of limited excision and locking plate fixation, interlocking intramedullary nailing and external fixation in treating tibial fractures.
From May 2007 to May 2011, 96 patients with tibial fractures were divided into three groups (Group A, Group B and Group C) and were treated with three kind of fixations including limited excision and locking plate fixation (36 cases in Group A, including 24 males and 12 females), interlocking intramedullary mailing (38 cases in Group B, including 22 males and 16 females) and external fixation (22 cases in Group C, including 12 males and 10 females). Operative time, healing time, weight-bearing time and complications were observed. Johner-Wruhs scoring was used to evaluate the function of lower limbs.
All patients were followed up from 3 months to 30 months with an average of 13 months. In Group A, the operative time was (85.01 +/- 12.2) minutes; the healing time was (143.0 + 12.3) days; the weight-bearing time was (114.3 +/- 12.2) days; Complications occured in 3 patients. According to Johner-Wruhs scoring, the results were rated as excellent in 21 cases, good in 12 cases, moderate in 2 cases, and poor in 1 case; In Group B, the operative time was (90.0 +/- 14.6) minutes; the healing time was (132.0 +/- 14.6) days; the weight-bearing time was (46.0 +/- 12.2) days; Three patients occurred complications. According to Johner-Wruhs scoring,the results were rated as excellent in 24 cases, good in 11 cases, moderate in 2 cases, and poor in 1 case. In Group C, the operative time was (70.0 +/- 10.2) minutes; the healing time was (121.0 +/- 13.5) days; the weight-bearing time was (108.2 +/- 8.9) days; Two patients underwent complications. According to Johner-Wruhs scoring, the results were rated as excellent in 16 cases, good in 5 cases, moderate in 0 case, and poor in 1 case. There were no significant significance among three groups in operative time, healing time, complications and the lower limbs function recovered (P > 0.05). But weight-bearing time in interlocking intramedullary nailing was better than in limited excision and locking plate fixation and external fixation (P < 0.05).
Different fixation methods have different advantages. Limited excision,closed reduction with locking plate fixation is an ideal method to treat the tibial fracture.
比较有限切开锁定钢板内固定、交锁髓内钉内固定及外固定治疗胫骨骨折的疗效。
2007年5月至2011年5月，将96例胫骨骨折患者分为三组（A组、B组和C组），分别采用有限切开锁定钢板内固定（A组36例，男24例，女12例）、交锁髓内钉内固定（B组38例，男22例，女16例）和外固定（C组22例，男12例，女10例）三种固定方法治疗。观察手术时间、愈合时间、负重时间及并发症情况。采用Johner-Wruhs评分评价下肢功能。
所有患者均获随访，随访时间3个月至30个月，平均13个月。A组手术时间为（85.01±12.2）分钟；愈合时间为（143.0 + 12.3）天；负重时间为（114.3±12.2）天；3例出现并发症。根据Johner-Wruhs评分，结果为优21例，良12例，可2例，差1例；B组手术时间为（90.0±14.6）分钟；愈合时间为（132.0±14.6）天；负重时间为（46.0±12.2）天；3例出现并发症。根据Johner-Wruhs评分，结果为优24例，良11例，可2例，差1例。C组手术时间为（70.0±10.2）分钟；愈合时间为（121.0±13.5）天；负重时间为（108.2±8.9）天；2例出现并发症。根据Johner-Wruhs评分，结果为优16例，良5例，可0例，差1例。三组手术时间、愈合时间、并发症及下肢功能恢复情况差异均无统计学意义（P＞0.05）。但交锁髓内钉内固定的负重时间优于有限切开锁定钢板内固定及外固定（P＜0.05）。
不同固定方法各有优势。有限切开、闭合复位锁定钢板内固定是治疗胫骨骨折的理想方法。
