詹义兵 李华 靳朝国 熊怀风

[摘要] 目的 分析外固定支架和有限內固定联合治疗在四肢创伤骨折中的应用效果。 方法 选取2019年4月至2020年1月本院收治的四肢创伤骨折患者64例。按患者就诊顺序编号，并采取随机抽签法分为对照组和观察组，每组各32例。对照组采用传统外固定治疗，观察组采用有限内固定联合外固定支架治疗。对比分析两组治疗效果。 结果 治疗后， 观察组优良率为96.87%，明显高于对照组的81.25%，差异有统计学意义（P<0.05）。观察组患者骨折部位愈合时间明显短于对照组，差异有统计学意义（P<0.05）;两组治疗前生活质量评分比较，差异无统计学意义（P>0.05），随访半年，观察组生活质量评分为（88.6±4.4）分，明显高于对照组的（80.6±3.3）分，差异有统计学意义（P<0.05）。观察组术后并发症总发生率为6.25%，明显低于对照组的25.00%，差异有统计学意义（P<0.05）。结论 对于四肢创伤骨折患者来说，采取外固定支架联合有限内固定治疗可有效提升固定效果，促进骨折愈合，减少术后并发症的发生，保证患者术后生活质量及生活自理能力的提升。

[关键词] 四肢创伤骨折;外固定支架;有限内固定;骨折愈合时间;生活质量;并发症

[中图分类号] R687.3          [文献标识码] B          [文章编号] 1673-9701（2021）08-0076-03

Application of combined treatment of external fixator and limited internal fixation in the treatment of traumatic fractures of extremities

ZHAN Yibing   LI Hua   JIN Chaoguo   XIONG Huaifeng

The Third Department of Orthopedics， the Third People′s Hospital of Jingzhou City in Hubei Province， Jingzhou   434000， China

[Abstract] Objective To analyze the application effect of combined treatment of external fixator and limited internal fixation in the treatment of traumatic fractures of extremities. Methods All 64 cases were selected from patients with traumatic fractures of extremities admitted to our hospital from April 2019 to January 2020. The patients were numbered according to the admission order and were divided into groups by a random lottery method， with 32 cases in each group. The control group included patients treated with traditional external fixation， and the observation group included patients treated with limited internal fixation combined with external fixation. The treatment effects of the two groups were comparatively analyzed. Results After treatment， the excellent and good rate was 96.87% in the observation group，which was significantly higher than that of 81.25% in the control group， and the difference was  statistically significant（P<0.05）. The fracture healing time in the observation group was significantly shorter than that in the control group，and the difference was  statistically significant（P<0.05）. There was no significant difference in the quality of life scores between the two groups before treatment（P>0.05）. After followed up for half a year， and the quality of life score in the observation group was （88.6±4.4） points， which was higher than that of  （80.6±3.3） points in the control group， and the difference was  statistically significant（P<0.05）. The total incidence of postoperative complications after treatment was 6.25% in the observation group， which was lower than that of 25.00% in the control group， and the difference was  statistically significant（P<0.05）. Conclusion For patients with traumatic fractures of extremities， the external fixator combined with limited internal fixation can effectively improve the fixation effect， promote fracture healing， reduce the occurrence of postoperative complications， and ensure the improvement of postoperative quality of life and self-care ability.

[Key words] Traumatic fractures of extremities; External fixation; Limited internal fixation; Fracture healing time; Quality of life; Complications

四肢创伤骨折在临床上比较常见，包括股骨干骨折、胫腓骨骨折、肱骨踝上骨折、尺桡骨干双骨折、Colles骨折以及股骨颈骨折等多种骨折类型。对于患者来说，四肢骨折愈合时间较长、影响较大，需要采取有效的治疗，一方面是有效固定，防止骨折部位受到二次创伤，另一方面是便于骨折部位尽早愈合[1]。就目前的手术治疗方法来看，内固定和外固定都是常用的治疗手段。内固定治疗需要借助骨板、金属螺钉等辅助手段，将断骨连接，保证骨折固定和愈合效果，但长期固定治疗可能引发感染或二次伤害[2]。而外固定支架治疗，可发挥较好的固定效果，且骨折部位止血快、并发症少，但容易出现骨折部位固定不稳，造成骨折愈合畸形等不良后果[3]。……