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[经皮锁定钢板与髓内钉治疗AO 42A - B型胫骨骨折的回顾性分析]

[Retrospective analysis of AO 42A-B type tibia fractures treated with percutaneus locked plating and intramedullary nailing].

作者信息

Bilgili Fuat, Kılıç Ayhan, Sökücü Sami, Parmaksızoğlu Atilla Sancar, Çepni Kamil Serdar, Kabukçuoğlu Yavuz Selim

机构信息

Department of Orthopaedics and Traumatology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey.

Department of Orthopaedics and Traumatology, Taksim Training and Research Hospital, İstanbul, Turkey.

出版信息

Ulus Travma Acil Cerrahi Derg. 2016 Jan;22(1):90-6. doi: 10.5505/tjtes.2015.56956.

Abstract

BACKGROUND

In this study, the results of AO 42A and 42B type tibia fractures treated with intramedullary nail (IMN) and percutaneus locking plate (PLP) were evaluated. The complications were examined, and it was questioned whether the type of fixation had an effect on union time and functional results.

METHODS

Forty-two patients with extraarticular distal tibial fractures were enrolled in this retrospective study. Eighteen patients were treated with closed IMN (Group I) and 24 patients were treated with PLP fixation (Group II). Mean age was 41 (range: 16-70) years; thirty-two of the patients were men. Fractures were classified according to the AO classification system. Union time, functional results and complications (malunion, malalignment, infection) were compared. The American Orthopaedic Foot and Ankle Surgery (AOFAS) scoring was used to compare functional results.

RESULTS

The average follow-up period was 20 (12-32) months for Group I and 23 (13-36) months for Group II. The average union time was 16 (12-24) weeks in Group I and 19 (range: 16-24) weeks in Group II (p=0.002). The AOFAS scoring was 85 (range: 69-100) points in Group I and 81 (range: 60-95) points in Group II. The difference in AOFAS scoring was not significant (p=0.06). Two patients had nonunion in Group II. Two patients in Group I and three patients in Group II had malalignment.

DISCUSSION

We suggest that IMN can provide early healing time. Although it is not statistically significant, complication rate was lower and functional results were better in patients treated with IMN.

摘要

背景

在本研究中,对采用髓内钉(IMN)和经皮锁定钢板(PLP)治疗的AO 42A和42B型胫骨骨折的结果进行了评估。检查了并发症,并探讨了固定类型是否对愈合时间和功能结果有影响。

方法

42例胫骨干骺端骨折患者纳入本回顾性研究。18例患者采用闭合髓内钉治疗(I组),24例患者采用经皮锁定钢板固定(II组)。平均年龄为41岁(范围:16 - 70岁);其中32例为男性。骨折根据AO分类系统进行分类。比较愈合时间、功能结果和并发症(畸形愈合、对线不良、感染)。采用美国矫形足踝外科(AOFAS)评分比较功能结果。

结果

I组平均随访时间为20(12 - 32)个月,II组为23(13 - 36)个月。I组平均愈合时间为16(12 - 24)周,II组为19(范围:16 - 24)周(p = 0.002)。I组AOFAS评分为85(范围:69 - 100)分,II组为81(范围:60 - 95)分。AOFAS评分差异无统计学意义(p = 0.06)。II组有2例患者出现骨不连。I组有2例患者、II组有3例患者出现对线不良。

讨论

我们认为髓内钉可提供早期愈合时间。尽管无统计学意义,但髓内钉治疗的患者并发症发生率较低且功能结果更好。

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