| 韩进,路玉峰,万清明,等.数字化六轴外固定架和髓内钉固定治疗胫骨干骨折的回顾性对照研究.骨科,2023,14(6): 489-494. |
| 数字化六轴外固定架和髓内钉固定治疗胫骨干骨折的回顾性对照研究 |
| A Retrospective Comparative Study of Digital Six-axis External Fixator and Intramedullary Nail Fixation in the Treatment of Tibial Shaft Fracture |
| 投稿时间：2023-09-12 |
| DOI：10.3969/j.issn.1674-8573.2023.06.001 |
| 中文关键词: 胫骨骨折 数字化六轴外固定架 髓内钉 骨折固定术 临床疗效 对照研究 |
| 英文关键词: Tibial fractures Digital six-axis external fixator Intramedullary nail Fracture fixation Clinical efficacy Comparative study |
| 基金项目:陕西省重点研发基金项目（2019SF-192）；陕西省自然科学基础研究计划项目（2022JM-546） |
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| 中文摘要: |
| 目的 对比分析数字化六轴（QSF）外固定架和髓内钉治疗胫骨干骨折的临床疗效。方法 采用回顾性病例对照研究分析2017年1月至2020年12月西安交通大学附属红会医院中西医结合骨科收治的98例胫骨干骨折病人的临床资料，其中男69例，女29例，年龄为（40.98±13.81）岁（16~71岁）。48例采用数字化六轴外固定架固定手术治疗（QSF外固定组），50例采用髓内钉固定手术治疗（髓内钉组），比较两组围手术期资料：手术时间、术中出血量、透视次数、下地负重时间等；其他随访及影像资料：完全负重时间、下肢功能量表（LEFS）评分、骨折愈合时间、骨折复位效果（术后成角及移位情况）、并发症等。结果 QSF外固定组病人均采用闭合复位骨折；髓内钉组有7例病人切开复位骨折，其余病人采用闭合复位骨折。所有病人均未发生血管神经损伤等严重并发症。病人随访（29.38±10.1）个月（12~44个月）。QSF外固定组手术时间、术中出血量、透视次数、下地负重时间、完全负重时间、骨折愈合时间、骨折复位质量显著优于髓内钉组（P＜0.05）；两组住院时间、切口愈合情况、膝关节屈曲活动度、踝关节跖屈活动度、踝关节背伸活动度的差异无统计学意义（P＞0.05）。在术后1年的末次随访中，QSF外固定组病人LEFS评分显著高于髓内钉组（P＜0.05）。结论 与髓内钉固定相比，QSF外固定架治疗胫骨干骨折创伤更小、复位效果好、开始及完全负重时间早、骨折愈合时间更短、取出简单。 |
| 英文摘要: |
| Objective To compare and analyze the clinical effects of digital six-axis (QSF) external fixator and intramedullary nail in the treatment of tibiofibular fracture. Methods A retrospective case-control study was conducted to analyze the clinical data of 98 patients with tibial fracture treated in the Department of Orthopaedics of Integrated Traditional Chinese and Western Medicine, Xi'an Honghui Hospital from January 2017 to December 2020, including 69 males and 29 females, aged (40.98±13.81) years ole (16-71 years). A total of 48 cases were treated with QSF external fixator (QSF external frame group) and 50 cases were treated with intramedullary nail (intramedullary nail group). The perioperative data of the two groups were compared: operation time, intraoperative blood loss, fluoroscopy times, weight-bearing time. Other follow-up and imaging data were as follows: complete weight-bearing time, lower limb function score, fracture healing time, fracture reduction effect (postoperative angulation and displacement), complications. Results All the patients in the QSF external frame group were treated with closed reduction, 7 patients in the intramedullary nail group were treated with open reduction, and the rest patients were treated with closed reduction. No serious complications such as vascular and nerve injury occurred in all patients. All patients were followed up for (29.38±10.1) months (12-44 months). The QSF external frame group was significantly superior to the intramedullary nail group in operation time, intraoperative blood loss, fluoroscopy times, weight-bearing time, complete weight-bearing time, fracture healing time and fracture reduction quality (P＜0.05), but there was no significant difference in hospitalization time, incision healing, knee flexion range of motion, ankle metatarsal flexion range of motion and ankle dorsal extension range of motion (P＞0.05). During the last follow-up more than one year after operation, the scores of lower limb function in the QSF external frame group were significantly higher than those in the intramedullary nail group. Conclusion Compared with intramedullary nail fixation, QSF external fixator in the treatment of tibial shaft fracture has the advantages of less surgical trauma, better reduction effect, earlier start and complete weight bearing time, shorter fracture healing time, and simple removal. |
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