空心钉内固定与传统张力带内固定治疗髌骨骨折的疗效对比
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摘要
目的对比评价空心钉内固定与传统张力带内固定治疗髌骨骨折的疗效。方法方便选取该院自2015年10月—2017年10月这段期间内接收治疗的髌骨骨折患者60例作为临床研究对象,将之按照随机对照分组法分成两组:一组为空心钉组(30例),均采用空心钉内固定治疗;一组为张力带组(30例),均采用传统张力带内固定治疗;观察比较两组的手术时间、术中出血量及随访6个月后的Cassebaum评分。结果空心钉组的平均手术时间为(41.8±11.9)min,张力带组的平均手术时间为(58.2±17.4)min,空心钉组的平均手术时间显著短于张力带组(t=22.518,P<0.05)。空心钉组的平均术中出血量为(72.2±14.3)mL,张力带组的平均术中出血量为(86.4±19.7)mL,空心钉组的平均术中出血量显著少于张力带组(t=19.275,P<0.05)。空心钉组中Cassebaum评分优良29例,优良率为96.7%;张力带组中Cassebaum评分优良20例,优良率为66.7%;空心钉组的Cassebaum评分优良率显著高于张力带组(χ2=25.312,P<0.05)。结论采用空心钉内固定治疗髌骨骨折对软组织刺激较小,比传统张力带内固定治疗的效果更好、操作更简单,值得临床应用及推广。
Objective To evaluate the efficacy of cannulated internal fixation and conventional tension band internal fixation for the treatment of tibiofibular fractures. Methods 60 patients with tibiofibular fractures who received treatment from October 2015 to October 2017 were conveniently selected as clinical subjects. They were divided into two groups according to the "randomized control grouping method": one group was a hollow nail group.(30 cases) were treated with cannulated screws; one group was tension band group(30 cases), all of them were treated with traditional tension band internal fixation;the operation time, intraoperative blood loss and 6 months follow-up were compared between the two groups after the Cassebaum score. Results The average operation time of the cannulated nail group was(41.8±11.9)min, and the average operation time of the tension band group was(58.2±17.4)min. The average operation time of the cannulated nail group was significantly shorter than that of the tension band group(t=22.518, P<0.05). The average intraoperative blood loss in the cannulated nail group was(72.2±14.3)mL, and the mean intraoperative blood loss in the tension band group was(86.4±19.7)mL. The average intraoperative blood loss in the cannulated nail group was significantly less than that in the tension band group(t=19.25, P<0.05). In the cannulated nail group, the Cassebaum score was excellent in 29 cases, the excellent and good rate was 96.7%; the Cassebaum score in the tension band group was excellent in 20 cases, the excellent and good rate was66.7%; the excellent rate of the Cassebaum score in the cannulated nail group was significantly higher than that in the tension band group(χ2=25.312, P<0.05). Conclusion The treatment of tibiofibular fracture with cannulated screw fixation has less soft tissue stimulation than traditional tension band internal fixation. It is worthy of clinical application and promotion.
Objective To evaluate the efficacy of cannulated internal fixation and conventional tension band internal fixation for the treatment of tibiofibular fractures. Methods 60 patients with tibiofibular fractures who received treatment from October 2015 to October 2017 were conveniently selected as clinical subjects. They were divided into two groups according to the "randomized control grouping method": one group was a hollow nail group.(30 cases) were treated with cannulated screws; one group was tension band group(30 cases), all of them were treated with traditional tension band internal fixation;the operation time, intraoperative blood loss and 6 months follow-up were compared between the two groups after the Cassebaum score. Results The average operation time of the cannulated nail group was(41.8±11.9)min, and the average operation time of the tension band group was(58.2±17.4)min. The average operation time of the cannulated nail group was significantly shorter than that of the tension band group(t=22.518, P<0.05). The average intraoperative blood loss in the cannulated nail group was(72.2±14.3)mL, and the mean intraoperative blood loss in the tension band group was(86.4±19.7)mL. The average intraoperative blood loss in the cannulated nail group was significantly less than that in the tension band group(t=19.25, P<0.05). In the cannulated nail group, the Cassebaum score was excellent in 29 cases, the excellent and good rate was 96.7%; the Cassebaum score in the tension band group was excellent in 20 cases, the excellent and good rate was66.7%; the excellent rate of the Cassebaum score in the cannulated nail group was significantly higher than that in the tension band group(χ2=25.312, P<0.05). Conclusion The treatment of tibiofibular fracture with cannulated screw fixation has less soft tissue stimulation than traditional tension band internal fixation. It is worthy of clinical application and promotion.
引文
[1]吕鹏起.空心拉力螺钉内固定与克氏针张力带治疗髌骨骨折的疗效与安全性对比[J].浙江创伤外科,2018,23(1):126-127.
[2]李金亮,张晓光,杨飞.空心钉内固定与传统张力带内固定治疗髌骨骨折的疗效对比[J].宁夏医科大学学报,2017,39(12):1447-1449.
[3]毛玲娣.髌骨骨折术后早期及延迟康复治疗介入的临床疗效对比[J].数理医药学杂志,2017,30(9):1313-1314.
[4]刘晓萍.创伤性骨折患者护理中舒适护理的临床应用效果观察[J].临床医学研究与实践,2017,2(22):181-182.
[5]练文俊.空心钉结合张力带内固定与克氏针张力带内固定治疗髌骨横形骨折疗效对比[J].临床医药文献电子杂志,2017,4(30):5770.
[6]谢维,刘奎,竺义亮,等.空心钉结合张力带内固定与克氏针张力带内固定治疗髌骨横形骨折疗效对比[J].双足与保健,2017,26(7):131-132.
[7]冯青,景孟军,吴明义,等.AO克氏针张力带和金属骨针内固定治疗髌骨骨折的疗效比较[J].中国骨与关节损伤杂志,2014,29(8):824-825.
[8]应兴红.空心钉结合张力带内固定与克氏针张力带内固定治疗髌骨横形骨折疗效对比[J].中外医学研究,2014,12(31):41-42.
[2]李金亮,张晓光,杨飞.空心钉内固定与传统张力带内固定治疗髌骨骨折的疗效对比[J].宁夏医科大学学报,2017,39(12):1447-1449.
[3]毛玲娣.髌骨骨折术后早期及延迟康复治疗介入的临床疗效对比[J].数理医药学杂志,2017,30(9):1313-1314.
[4]刘晓萍.创伤性骨折患者护理中舒适护理的临床应用效果观察[J].临床医学研究与实践,2017,2(22):181-182.
[5]练文俊.空心钉结合张力带内固定与克氏针张力带内固定治疗髌骨横形骨折疗效对比[J].临床医药文献电子杂志,2017,4(30):5770.
[6]谢维,刘奎,竺义亮,等.空心钉结合张力带内固定与克氏针张力带内固定治疗髌骨横形骨折疗效对比[J].双足与保健,2017,26(7):131-132.
[7]冯青,景孟军,吴明义,等.AO克氏针张力带和金属骨针内固定治疗髌骨骨折的疗效比较[J].中国骨与关节损伤杂志,2014,29(8):824-825.
[8]应兴红.空心钉结合张力带内固定与克氏针张力带内固定治疗髌骨横形骨折疗效对比[J].中外医学研究,2014,12(31):41-42.