摘要
目的评价螺纹无头加压空心螺钉与解剖板治疗少年胫骨远端三平面骨折的效果。方法选择2017年1月至2020年6月河北工程大学附属医院骨外科治疗的48例胫骨远端三平面骨折少年患者,根据患者意愿进行分组,将选择采用螺纹无头加压空心螺钉治疗的24例患者作为研究组,选择采用解剖板固定术治疗的24例患者作为对照组。比较两组切口长度、手术时间、术中出血量、术后出血量;比较两组愈合时间、术后下地时间、视觉模拟评分法(VAS)评分和皮瓣坏死率;比较两组不良反应发生情况,比较两组的关节功能改善情况。结果研究组切口长度、手术时间短于对照组,术中出血量、术后出血量均少于对照组,差异有统计学意义(P<0.05);研究组愈合时间、术后下地时间均短于对照组,差异有统计学意义(P<0.05);两组VAS评分和皮瓣坏死率比较,差异无统计学意义(P>0.05);两组术后均有轻微肢体肿胀,两组均无严重不良反应发生。研究组关节功能改善率高于对照组,差异有统计学意义(P<0.05)。结论螺纹无头加压空心螺钉在治疗胫骨远端骨折上,创伤小,出血少,可更好地保护骨膜,骨折愈合快,更有利于关节功能的恢复,虽然两种方案均具有较好的解剖学稳固作用,但是螺纹无头加压空心螺钉更有优势,值得推广。
Objective To evaluate the effect of threaded headless compression cannulated screw and anatomical plate in the treatment of triplane fracture of distal tibia in juvenile.Methods A total of 48 juvenile patients with triplane fracture of distal tibia treated in the Department of Orthopedics,Affiliated Hospital of Hebei Engineering University from January 2017 to June 2020 were selected.According to patients’wishes,24 patients treated with threaded headless compression cannulated screw were selected as the study group,and 24 patients treated with anatomic plate fixation were selected as the control group.The incision length,operation time,the amount of intraoperative blood loss and postoperative blood loss were compared between the two groups.The healing time,postoperative time to ground,visual analogue scale(VAS)score and the necrosis rate of skin flap were compared between the two groups.The incidence of adverse reactions was compared between the two groups,and the improvement of joint function was compared between the two groups.Results The incision length and operation time in the study group were shorter than those in the control group,and the amount of intraoperative blood loss and postoperative blood loss in the study group were less than those in the control group,with statistical significance(P<0.05).The healing time and postoperative time to ground of the study group were shorter than those of the control group,with statistical significance(P<0.05).There was no significant difference in VAS score and necrosis rate of skin flap between the two groups(P>0.05).Both groups had slight limb swelling after operation,and no serious adverse reactions occurred in both groups.The improvement rate of joint function in the study group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion In the treatment of distal tibial fracture,threaded headless compression cannulated screw has less trauma,less bleeding,better protection of periosteum,faster fracture healing,and more conducive to the recovery of joint function.Although both schemes have better anatomical stabilization,threaded headless compression cannulated screw has more advantages and is worthy of promotion.
作者
马智林
乔国勇
冯文方
段晓伟
陈欣志
张永涛
牛静
刘志春
MA Zhilin;QIAO Guoyong;FENG Wenfang;DUAN Xiaowei;CHEN Xinzhi;ZHANG Yongtao;NIU Jing;LIU Zhichun(The Second Department of Orthopedics,Affiliated Hospital of Hebei Engineering University,Hebei Province,Handan056002,China;Department of Trauma Emergency,Handan Central Hospital,Hebei Province,Handan056002,China;Department of Neurosurgery,Handan Central Hospital,Hebei Province,Handan056002,China;Department of Ultrasound,Affiliated Hospital of Hebei Engineering University,Hebei Province,Handan056002,China;Department of Hepatological Surgery,Hebei Petro China Central Hospital,Hebei Province,Handan065000,China)
出处
《中国医药导报》
CAS
2021年第21期84-87,共4页
China Medical Herald
基金
邯郸市科学技术研究与发展计划项目(1723208068-6)
河北省重点研发计划自筹项目(172777148)。
关键词
解剖板
胫骨远端三平面骨折
螺纹无头加压空心螺钉
关节功能改善
Anatomical plate
Triplane fracture of distal tibia
Threaded headless compression cannulated screw
Joint function improvement
作者简介
马智林(1983.8-),男,硕士,研究方向:关节外科。;通讯作者:乔国勇。
