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外固定支架术后行内固定治疗对胫腓骨骨干开放性骨折患者的疗效分析
Curative effect of internal fixation on patients with open tibiofibular fractures after external fixator surgery
投稿时间:2021-08-12  修订日期:2022-05-13
DOI:
中文关键词:  胫腓骨骨折  开放性骨折  外固定支架  内固定术  预后
英文关键词:Tibiofibular fracture  Open fracture  External fixator  Internal fixation  Prognosis
基金项目:
作者单位E-mail
董乃健 宁德师范学院附属宁德市医院 dnaijian8493@163.com 
李平* 宁德师范学院附属宁德市医院 liping84115@163.com 
柯铭锋 宁德师范学院附属宁德市医院  
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中文摘要:
      目的 探究外固定支架术后行内固定治疗对胫腓骨骨干开放性骨折患者的影响。方法 选取2018年1月至2021年1月宁德师范学院附属宁德市医院收治的87例胫腓骨骨干开放性骨折患者为研究对象,根据手术方式分为A组(42例)和B组(45例),A组采用外固定支架术治疗,B组采用外固定支架术后行内固定治疗。比较两组患者的骨折愈合情况、下肢功能及自理能力恢复情况、骨代谢标志物含量、炎症反应及并发症发生率。结果 患者均获随访6 ~ 8个月。B组患者的骨痂形成时间、疼痛消失时间、骨折愈合时间均少于A组,术后6个月B组骨折愈合率高于A组(P<0.05);术后3个月及术后6个月,B组患者的膝踝关节功能恢复评分(Merchant)、简式Fugl-Meyer(FMA)下肢运动量表评分、生活自理能力恢复有效性(BE)值均高于A组(P<0.05)。术后1周,B组患者的骨碱性磷酸酶(BALP)、骨钙素(BGP)、血清I型前胶原羧基端肽(PICP)含量均高于A组(P<0.05);B组患者的C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平均低于A组(P<0.05);B组患者的并发症总发生率低于A组(P<0.05)。结论 采用外固定支架术后行内固定治疗胫腓骨骨干开放性骨折安全有效,能够缩短骨折端与创面的愈合进程,促进患者功能恢复,减少并发症的发生,改善预后。
英文摘要:
      Objective To explore the effects of internal fixation on patients with open tibiofibular fractures after external fixator surgery.Methods A total of 87 patients with open tibiofibular fractures admitted to Ningde Hospital Affiliated to Ningde Normal University were enrolled as the research objects between January 2018 and January 2021. According to different surgical methods, they were divided into group A (42 cases, external fixator) and group B (45 cases, internal fixation after external fixator). The fracture healing, recovery of lower limb function and self-care ability, levels of bone metabolism markers, inflammation response and incidence of complications were compared between the two groups.Results All patients were followed up for 6-8 months. The porosis time, disappearance time of pain and fracture healing time in group B were shorter than those in group A. At 6 months after surgery, fracture healing rate in group B was higher than that in group A (P<0.05). At 3 and 6 months after surgery, scores of knee-ankle function recovery (Merchant), simple Fugl-Meyer Assessment (FMA), and Barthel effectiveness (BE) of self-care ability in group B were higher than those in group A (P<0.05). At 1 week after surgery, levels of bone alkaline phosphatase (BALP), bone gla protein(BGP) and serum propeptide of type I procollagen (PICP) in group B were higher than those in group A (P<0.05), levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were lower than those in group A (P<0.05), and total incidence of complications was lower than that in group A (P<0.05).Conclusion The internal fixation is safe and effective after external fixator surgery. It can shorten the healing process of fractures and wounds, promote function recovery, reduce the occurrence of complication and improve prognosis of patients.
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