胫骨远端髓内钉与胫骨远端锁定接骨板治疗胫腓骨远端骨折的疗效

摘要

目的:探讨胫骨远端髓内钉与加压锁钉接骨板手术(LCP)对胫腓骨远端骨折(DTF)的治疗效果.方法:将120例DTF患者随机分为观察组和对照组,观察组采用LCP术式治疗,对照组采用复位髓内钉内固定手术(ORIF)术式治疗,对比两组患者的手术时间、骨折愈合时间、切口长度及术中出血量;在手术前、手术后6个月采用Johner-Wruh量表和K-AJFS评分评价术后膝、踝关节功能康复效果,WHOQOL-I00量表评分评价患者生存质量.比较两组患者的中短期疗效.结果:观察组患者手术时间、骨折愈合时间显著短于对照组,切口长度及术中出血量显著低于对照组'差异有统计学意义(P<0.05);术后6个月,观察组患者Johner-Wruh量表评级结果及功能康复优良率均显著优于对照组,差异有统计学意义(P<0.05);两组患者术后6个月K-AJFS评分、WHOQOL-100量表评分较术前显著提高,观察组术后两项评分高于同时段对照组,差异有统计学意义(P<0.05);观察组临床疗效及治疗总有效率均显著优于对照组,差异具统计学意义(P<0.05).结论:LCP术式治疗胫腓骨远端骨折的疗效确切,更有利于DTF患者膝踝关节曲伸、运动功能的康复.%Objective: To investigate the efficacy of distal tibial intramedullary nail and compression screw plate osteosynthesis(LCP) on distal tibiofibular fractures(DTF). Methods: 120 patients with DTF were randomly divided into the observation group and the control group.60 patients in the observation group were treated with LCP and 60 patients in the control group were treated with the reduction intramedullary nail internal fixation(ORIF). Comparing the operation time, fracture healing time, incision length and intraoperative blood loss between the two groups of patients. The functional recovery of the knee and ankle joints was evaluated by Johner-Wruh scale and K-AJFS score. The WHOQOL-100 scale was used to evaluate the quality of life of the patients and to compare short-term and midterm efficacy of patients in both groups. Results: The operation time and fracture healing time of the observation group were significantly shorter than those of the control group. The incision length and blood loss during the operation were significantly lower than those of the control group(P＜ 0.05). The patients in the observation group at the 6th month after operation showed better Johner-The Wruh scale rating results and functional rehabilitation rate than the control group, the difference was statistically significant(P＜ 0.05) . The postoperative K-AJFS scores, WHOQOL-l00 scale scores were significantly higher than before the surgery. The postoperative scores in the observation group were higher than those in the control group at the same time(P＜ 0.05). The clinical efficacy and total treatment efficiency in the observation group were significantly better than those in the control group, and the difference was statistically significant(P＜ 0.05). Conclusion: LCP is effective in the treatment of distal radius fractures, which is more conducive to the rehabilitation of knee joints in DTF patients.