摘要
目的探讨胫骨下段螺旋型骨折在无X线透视下应用微创切口+内侧经皮锁定钢板治疗的临床效果。方法前瞻性选择2020年1月-2020年8月我院收治的60例胫骨下段螺旋型骨折患者,根据电脑随机盲选法,分为观察组和对比组,各30例。对比组应用传统切口锁定钢板术治疗,观察组在无X线透视下实施微创切口+内侧经皮锁定钢板治疗。比较两组手术指标,同时于术前、术后1年比较两组踝与后足功能评分(AOFAS)、血清白细胞(WBC)、血红蛋白(HGB)、超敏C反应蛋白(hs-CRP)、血沉(ESR)、治疗效果及预后。结果观察组手术时间、骨痂形成时间、骨折愈合时间均短于对比组,创口大小小于对比组,差异有统计学意义(P<0.05)。术后1年,两组AOFAS评分系统中的疼痛评分、功能评分、力线评分、WBC、HGB、hs-CRP、ESR均上升,且观察组高于对比组,差异有统计学意义(P<0.05);观察组治疗优良率(80.00%)高于对比组(73.33%),并发症发生率(6.66%)低于对比组(26.67%),但差异均无统计学意义(P>0.05)。观察组二次处理率(3.33%)低于对比组(20.00%),差异无统计学意义(P>0.05)。结论微创切口+内侧经皮锁定钢板治疗胫骨下段螺旋型骨折,具有手术时间短、创伤小、对踝与后足功能影响小等优点,在无X线透视下实施,可减少X线对患者的影响,利于血常规指标的恢复,还可降低并发症及二次处理风险,在基层医院可实施性高。
Objective To investigate the clinical effect of minimally invasive incision+medial percutaneous locking plate in the treatment of distal tibial spiral fractures without X-ray fluoroscopy.Methods Sixty patients with spiral fracture of the lower tibia admitted to our hospital from January 2020 to August 2020 were selected and divided into observation group and control group according to computer random blind selection method,with 30 cases in each group.The control group was treated with traditional incision locking plate,and the observation group was treated with minimally invasive incision+medial percutaneous locking plate without X-ray fluoroscopy.The surgical indexes of the two groups were compared.At the same time,the ankle and hindfoot function scores(AOFAS),serum white blood cells(WBC),hemoglobin(HGB),high-sensitivity C-reactive protein(hs-CRP),erythrocyte sedimentation rate(ESR),treatment effect and prognosis of the two groups were compared before and 1 year after operation.Results The operation time,callus formation time and fracture healing time of the observation group were shorter than those of the control group,and the wound size was less than that of the control group,the difference was statistically significant(P<0.05).One year after operation,the pain score,functional score,force line score,WBC,HGB,hs-CRP and ESR in the AOFAS scoring system of the two groups were increased,and those in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).The excellent and good rate of treatment in the observation group(80.00%)was higher than that in the control group(73.33%),and the incidence of complications(6.66%)was lower than that in the control group(26.67%),but the differences were not statistically significant(P>0.05).The secondary treatment rate of the observation group(3.33%)was lower than that of the control group(20.00%),and the difference was not statistically significant(P>0.05).Conclusion Minimally invasive incision+medial percutaneous locking plate in the treatment of spiral fractures of the lower tibia has the advantages of short operation time,small trauma,and small influence on ankle and hindfoot functions.The implementation without X-ray fluoroscopy can reduce the influence of X-ray on patients,which is conducive to the recovery of blood routine indexes,and can also reduce the risk of complications and secondary treatment,which is highly feasible in primary hospitals.
作者
郑义海
向明
汪爱兰
江有华
袁梦龙
ZHENG Yi-hai;XIANG Ming;WANG Ai-lan;JIANG You-hua;YUAN Meng-long(Department of Integrated Traditional Chinese and Western Medicine,Jingdezhen Fourth People's Hospital,Jingdezhen 333000,Jiangxi,China)
出处
《医学信息》
2021年第23期69-72,共4页
Journal of Medical Information
关键词
胫骨下段螺旋型骨折
无X线透视
切口锁定钢板
微创切口
内侧经皮锁定钢板
Spiral fracture of lower tibia
Without X-ray fluoroscopy
The incision locking plate
Minimally invasive incision
Medial percutaneous locking plate
作者简介
郑义海(1976.12-),男,江西景德镇人,本科,主治医师,主要从事骨外科工作。
