韩繁体
胫骨髓内钉术后，应早期负重还是晚期负重？
盘古传说
髓内钉固定已成为胫骨干骨折固定的金标准，关于术后早期vs晚期负重问题，仍无确切定论。针对此问题，国外学者进行了相关研究，结果发表在2021.06 Injury期刊上。
王者荣耀q版
Objectives（目的）
这项多中心研究的目的是评估早期负重组(EWB)和非负重组(NWB)在髓内钉(IMN)治疗胫骨干骨折后，通过X线评估内植物失败和骨愈合率及步行能力的差异。
[Objectives: The purpo of this multicenter study was to asss the differences in the rates of implant failure and bone union by X-ray examination, and walking ability between an early weight-bearing group (EWB) and a non-weight-bearing group (NWB) following treatment with intramedullary nailing (IMN) for tibial shaft fractures with a propensity score-matching method.]闹铃铃声
Materials and Methods（方法）
我们收集了336名接受手术治疗的胫骨骨折患者的数据。排除随访失败和多发伤患者。最后，将263名患者分为两组，早期负重(EWB)组，其中鼓励在四周内进行部分负重行走；以及非负重(NWB)组，其中不允许在四周内负重。为了调整各组之间的基线差异，使用倾向评分算法将EWB组和NWB组以1:1的比例匹配，每组75例。匹配后，我们比较了两组的内植物失败率、术后6个月和1年的骨愈合率以及末次随访时的行走能力。安卓系统的电视机
[Material and Methods: We collected data from 336 patients with tibia fractures that were treated surgically. We excluded patients lost to follow-up and polytrauma patients. Finally, 263 patients were included who were divided into two groups, the early weight-bearing (E
WB) group, in which partial weightbearing walking within four weeks was encouraged, and a non-weight-bearing (NWB) group, in which no weight bearing was allowed for more than four weeks. To adjust for baline differences between groups, a propensity score algorithm was ud to match the EWB group with the NWB group in a 1:1 ratio of 75 cas each. After matching, we compared the rate of implant failure, the rate of bone union at six months and one year after surgery, and walking ability at the last follow-up between the two groups.]
表1：病例纳入流程
表2：两组患者基线资料
Results（结果）
杞人忧天原文
EWB组75例患者中无内植物失效，NWB组75例患者中有1例发生内植物失败(P = 1.0)。E
WB组75例患者中有20名(26%)在6个月时出现骨愈合延迟，NWB组75名患者中有13名(17%)出现骨愈合延迟；EWB组75名患者中有5名(6.7%)在1年时出现骨愈合延迟，NWB75名患者中有3名(4%)出现骨愈合延迟。EWBNMS评分的中位数为9(4–9)，NWB为9(0–9)。
[Results: Implant failure occurred in 0 of 75 patients in the EWB group vs. 1 of 75 in the NWB group (P = 1.0). Delayed bone union at six months occurred in 20 of 75 (26%) vs. 13 of 75 (17%) patients, and that at one year occurred in 5 of 75 (6.7%) vs. 3 of 75 (4%) patients. The median New Mobility Score was 9 (4–9) vs. 9 (0–9) points.]
表3：两组术后并发症及功能比较
Conclusion（结论）
团结
EWB组和NWB组在内植物失败率、术后6个月和1年的骨愈合率以及行走能力方面没有统计学上的显著差异。我们建议在胫骨干骨折髓内钉治疗后进行早期负重指导可能是无害的。
如果有来生三毛[Conclusion: There were no statistically significant differences in the rate of implant failure, the rates of the bone union at six months and one year after surgery, and walking ability between the EWB group and NWB group. We suggest that instruction in early weight-bearing after IMN nailing for tibial shaft fracture may not be harmful.]
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