三种固定方式治疗Gustilo ⅢA-B型开放性胫骨骨折的对比Comparison of three fixation techniques for open tibial fractures of Gustilo type ⅢA-B
曾文波;李姣;郝东阳;兰生辉;陈美玲;魏世隽;刘曦明;
摘要(Abstract)：
[目的]比较三种固定方式对GustiloⅢA-B型开放性胫骨骨折的治疗效果。[方法]回顾性分析2008年1月～2014年12月本院手术治疗的80例GustiloⅢA-B型胫骨开放性骨折患者。按治疗方法:27例采取髓内钉(UTN)一期内固定,22例接受锁定钢板(LCP)一期内固定, 31例接受外固定支架(UEF)固定。记录患者相关资料,按照Johner-Wruhs评定标准进行患肢功能评价。[结果]三组患者在创伤严重度评分(ISS)、伤口污染程度、Gustilo-Anderson分型、按骨科创伤协会OTA分型、伤口创面覆盖方式方面的差异无统计学意义(P>0.05)。手术时间和术中失血量依次为LCP组> UTN组>UEF组,三组间差异有统计学意义(P<0.05)。所有患者随访24～60个月,平均(36.37±10.96)个月。三组患者在深部感染、骨髓炎、截肢、术后6个月愈合不良和12个月不愈合发生率方面的差异无统计学意义(P>0.05)。临床骨愈合时间三组间的差异无统计学意义(P>0.05)。末次随访时,按照JohnerWruhs评定标准评定优良率,UTN组为85.19%,LCP组为81.82%,UEF组为67.74%。[结论]在严格清创、结合置管冲洗和VAC的前提下,GustiloⅢA-B型胫骨开放性骨折采用Ⅰ期内固定方式治疗可以获得满意疗效。
关键词(KeyWords)： 开放性胫骨骨折;非扩髓胫骨髓内钉;锁定加压钢板;单侧外固定架
基金项目(Foundation): 国家自然科学基金资助项目(编号:81601902);; 湖北省自然科学基金项目(编号:2015CFB240);; 博士后科学基金项目(编号:2015M572817)
作者(Author): 曾文波;李姣;郝东阳;兰生辉;陈美玲;魏世隽;刘曦明;
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