旋入式自锁钉与加压钢板内固定法治疗Pilon胫骨骨折的效果及安全性对比

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[摘要]目的 分析旋入式自鎖钉和加压钢板内固定法治疗Pilon胫骨骨折的效果及安全性。方法 选取我院2015年6月～2016年7月收治的58例Pilon胫骨骨折患者，依据治疗方式的不同分为参照组和研究组，各29例。参照组予以加压钢板内固定治疗，研究组予以旋入式自锁钉治疗，比较两组的临床治疗效果。结果 研究组的恢复优良率为96.6%，高于参照组的72.4%，差异有统计学意义（P<0.05）。研究组的手术用时、住院天数、下床活动时间和骨折愈合时间短于参照组，术中出血量少于参照组，差异有统计学意义（P<0.05）。研究组的并发症发生率为3.4%，低于参照组的24.1%，差异有统计学意义（P<0.05）。结论 旋入式自锁钉治疗Pilon胫骨骨折效果理想，不仅降低了术后并发症发生率，还对患者的康复起到促进作用，值得临床推广应用。

[关键词]旋入式自锁钉；加压钢板内固定法；Pilon胫骨骨折；效果分析

[中图分类号] R683.42 [文献标识码] A [文章编号] 1674-4721（2017）07（a）-0078-03

Effect and safety comparison of screw-in self-locking nail and compression plate for internal fixation in the treatment of Pilon tibial fractures

ZHA Rui-rui1 LIN Kun-shan2

1.Medical Accident Technical Identification Center of Zhangzhou City in Fujian Province，Zhangzhou 363000，China；2.Department of Orthopedics，Southeast Hospital Affiliated to Xiamen University，Zhangzhou 363000，China

[Abstract]Objective To analyze the effect and safety of screw-in self-locking nail and compression plate for internal fixation in the treatment of Pilon tibial fractures.Methods From June 2015 to July 2016，58 patients suffering from Pilon tibial fractures admitted into our hospital were selected and evenly divided into the control group and the research group according to the different surgical methods，29 cases in each group.The control group was treated with compression plate，while the research group was given screw-in self-locking nail.The clinical therapeutic effect of the two groups was compared.Results The recovery excellent and good rate of the research group was 96.6%，which was higher than 72.4% of the control group，with significant difference （P<0.05）.The operation time，hospital stay，time being off bed and fracture healing time of the research group was shorter than that of the control group，and the amount of bleeding during operation of the research group was less than that of the control group，with significant difference （P<0.05）.The incidence rate of complication in the research group was 3.4%，which was lower than 24.1% of the control group，with significant difference （P<0.05）.Conclusion The effect of screw-in self-locking nail in the treatment of Pilon tibial fracture is ideal，which not only reduces the incidence rate of postoperative complications，but also promotes the rehabilitation of the patients，it is worthy of clinical promotion and application.

[Key words]Screw-in self-locking nail；Compression plate for internal fixation；Pilon tibial fracture；Effect analysis

在骨科疾病中胫骨骨折较为常见，且骨折部位会刺穿皮肤，若不能采取有效的治疗措施会引发多种后遗症，并对其膝关节造成损伤，限制其活动能力[1]。从目前的治疗方法来看，手术仍是治疗该疾病的有效手段，常见的治疗方法为加压钢板内固定治疗、自锁钉内固定治疗，虽然具有显著的治疗效果，但是术后均会出现并发症[2]。近年来，旋入式自锁钉应运而生，其凭借诸多优势被临床广泛应用[2-3]。本研究选取我院的Pilon胫骨骨折患者作为研究对象，比较旋入式自锁钉与加压钢板内固定法治疗Pilon胫骨骨折的效果及安全性，现报道如下。

1资料与方法

1.1一般资料

选取我院2015年6月～2016年7月收治58例Pilon胫骨骨折患者，所有患者均行影像学诊断。根据治疗方法的不同将入选患者分为研究组和参照组，各29例。研究组中，男18例，女11例；年龄24～60岁，平均（41.6±5.7）岁；其中20例开放性骨折，9例闭合性骨折；交通事故致伤15例，高处坠落致伤10例，重物砸伤4例。……