标题：外固定架联合髓内钉内固定治疗胫骨干开放性骨折疗效观察

      作者：李建平，崔兴杰，刘彦荣，刘震    府谷县人民医院骨科，陕西 榆林 721000

      卷次： 2020年31卷10期

      【摘要】 目的 观察外固定架联合髓内钉内固定治疗胫骨干开放性骨折的疗效。方法 选取 2017年 7月至 2019年 8月于府谷县人民医院诊治的 90例胫骨干开放性骨折患者，根据随机数表法分为对照组和观察组各45例。对照组患者采用单纯髓内钉内固定治疗，观察组患者采用外固定架联合髓内钉内固定治疗，比较两组患者的手术时间、骨折愈合时间、住院时间和治疗 6个月后的美国膝关节协会(AKS)评分、健康调查简表(SF-36)评分 、生活质量、治疗效果和并发症发生情况。结果 观察组和对照组患者的手术时间 [(81.32±2.41) min vs(98.56±4.53) min]、骨折愈合时间[(13.72±0.95)周 vs (15.06±0.17)周]、住院时间[(6.29±1.03)周 vs (8.28±1.15)周]比较，观察组明显短于对照组，差异均具有统计学意义(P<0.05)；与术后1周比较，两组患者术后6个月的AKS评分及SF-36评分均明显升高，且术后6个月，观察组和对照组患者AKS评分[(62.43±3.05)分、(57.20±2.56)分]及SF-36评分[(75.62±23.51)分、(67.54±16.52)分]比较，观察组明显高于对照组，差异均有统计学意义(P<0.05)；观察组患者的治疗总有效率为95.56%，明显高于对照组的77.78%，差异有统计学意义(P<0.05)；观察组患者术后并发症发生率为8.89%，明显低于对照组的26.67%，差异有统计学意义(P<0.05)。结论 外固定架联合髓内钉内固定术治疗胫骨干开放性骨折患者，不仅能够缩短手术时间、骨折愈合时间及住院时间，还能有效降低术后并发症发生率，对促进术后胫骨骨折的愈合和膝踝关节功能恢复有显著疗效。
      【关键词】 外固定架；髓内钉内固定；胫骨；骨折；开放性骨折；疗效
      【中图分类号】 R683.42 【文献标识码】 A 【文章编号】 1003—6350（2020）10—1260—03

Effect of external fixation combined with intramedullary nail internal fixation in the treatment of open tibialshaft fracture.
LI Jian-ping, CUI Xing-jie, LIU Yan-rong, LIU Zhen. Department of Orthopaedics, People's Hospital ofFugu County, Yulin 721000, Shaanxi, CHINA
【Abstract】 Objective To observe the effect of external fixation combined with intramedullary nail internal fix-ation on open tibial shaft fracture. Methods Ninety patients with open tibial shaft fracture treated in People's Hospitalof Fugu County from Jul. 2017 to Aug. 2019 were divided into control group and observation group according randomnumber table, with 45 patients in each group. The control group was treated with intramedullary nail internal fixation,while the observation group was treated with external fixation combined with intramedullary nail internal fixation. Theoperation time, fracture healing time, the length of hospital stay, the American Knee Society (AKS), SF-36 score, totaleffective rate, and complication rate were compared between the two groups. Results The operation time, the fracturehealing time, the length of hospital stay were (81.32±2.41) min, (13.72±0.95) weeks, (6.29±1.03) weeks in the observa-tion group, respectively, significantly shorter than (98.56±4.53) min, (15.06±0.17) weeks, (8.28±1.15) weeks in the con-trol group (P<0.05). Compared with one week after operation, the AKS score and SF-36 score of the two groups 6months after operation increased significantly (P<0.05). The AKS and SF-36 scores 6 months after operation of the ob-servation group were significantly higher than those of the control group (P<0.05): (62.43±3.05) vs (57.20±2.56), (75.62±23.51) vs (67.54±16.52). The total effective rate of the observation group was 95.56%, significantly higher than 77.78%of the control group (P<0.05). The incidence of complications in the observation group was 8.89%, which was signifi-cantly lower than 26.67% in the control group (P<0.05). Conclusion External fixation combined with intramedullarynail internal fixation for open tibial shaft fracture can effectively reduce the incidence of complications and promote thehealing of tibia and fibula fracture and recovery of knee and ankle joint function, and the operation time, fracture healingtime and hospitalization time are shorter.
      【Key words】 External fixation; Intramedullary nail internal fixation; Tibia and fibula; Fracture; Open fracture;Curative effect