den Outer A J, Meeuwis J D, Hermans J, Zwaveling A
Division of Surgery, Leiden University Hospital, The Netherlands.
Clin Orthop Relat Res. 1990 Mar(252):231-7.
The results of conservative (mainly, functional bracing) and operative treatment (mainly, plate fixation) have been compared in a retrospective study of 170 displaced noncomminutive tibial shaft fractures. The characteristics of the fractures in both treatment groups showed no significant differences. The follow-up analysis revealed no statistical differences in outcome between the two methods. However, because of the many factors analyzed and the restricted number of patients studied, it is impossible to compare all factors independently. Surgical treatment resulted in a higher rate of complications (such as implant failure, osteitis, and refracture) and a longer total hospitalization time. Conservative treatment showed a longer duration of fracture healing and a higher rate of malalignment. Malalignments of up to 10 degrees with no adverse effects have been seen so far. In conservative treatment, two fracture types were identified with a higher rate of malalignment: short oblique isolated tibial fractures and fully dislocated transverse crural fractures. Conservative therapy is favored, because there is less discomfort for the patient and the treatment is cost contained.
在一项对170例移位的非粉碎性胫骨干骨折的回顾性研究中，对保守治疗（主要是功能性支具）和手术治疗（主要是钢板固定）的结果进行了比较。两个治疗组骨折的特征无显著差异。随访分析显示，两种方法的结果无统计学差异。然而，由于分析的因素众多且研究的患者数量有限，不可能独立比较所有因素。手术治疗导致并发症发生率较高（如内固定失败、骨炎和再骨折）以及总住院时间较长。保守治疗显示骨折愈合时间较长且对线不良率较高。到目前为止，已观察到高达10度的对线不良且无不良影响。在保守治疗中，发现两种骨折类型的对线不良率较高：单纯短斜形胫骨骨折和完全脱位的横行小腿骨折。保守治疗更受青睐，因为患者的不适感较小且治疗费用可控。
