成年患者股骨干陈旧性骨折髓内钉内固定结合断端植骨的手术效果评价
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摘要
目的观察髓内钉内固定结合断端植骨治疗成年患者股骨干陈旧性骨折的临床疗效。方法选取2015年1月～2017年1月于我院就诊的股骨干陈旧性骨折患者36例,对其临床资料进行回顾性分析,其中采用髓内钉内固定治疗的18例患者为对照组,采用髓内钉内固定结合断端植骨的18例患者为观察组,对比两组患者的手术治疗效果。结果观察组患者术中出血量、术后引流量均显著多于对照组(P> 0.05);观察组患者手术时间显著长于对照组(P <0.05);观察组患者骨折愈合率显著高于对照组(P <0.05);且观察组患者的骨折愈合时间显著短于对照组(P <0.05);观察组患者的感染率、膝关节僵硬发生率、内容物松动断裂发生率显著高于对照组(P <0.05);且观察组患者的并发症发生率显著高于对照组(P <0.05)。结论采用髓内钉内固定结合断端植骨治疗成年患者股骨干陈旧性骨折,其手术时间较长,术中出血量较多,但术后并发症发生率显著降低,并缩短了患者的骨折愈合时间,以及提高了骨折愈合率,治疗效果良好,值得在临床上推广使用。
Objective To observe the clinical curative effect of intramedullary nail internal fixation combined with fracture bone grafting in treatment of adult patients with old femoral fracture.Methods 36 patients with old femoral fracture who were treated in our hospital from January 2015 to January 2017 were selected.Their clinical data were retrospectively analyzed.18 patients treated with intramedullary nail internal fixation were set as the control group and 18 patients treated with intramedullary nail internal fixation combined with fracture bone grafting were set as the observation group.The curative effect of operation in the two groups was compared.Results The intraoperative blood loss and postoperative drainage flow of patients in the observation group were significantly more than those in the control group(P > 0.05).The operation time in the observation group was significantly longer than that in the control group(P < 0.05).The healing rate of fractures in the observation group was significantly higher than that in the control group(P < 0.05).The healing time of fracture in the observation group was significantly shorter than that in the control group(P < 0.05).The incidence of infection,knee stiffness and loose and broken content in the observation group were all significantly higher than those in the control group(P < 0.05).And the incidence of complications in the observation group was significantly higher than that in the control group(P < 0.05).Conclusion Intramedullary nail internal fixation combined with fracture bone grafting in treatment of adult patients with old femoral fracture has a longer operation time and more intraoperative blood loss.But the incidence of complications is significantly reduced,the healing time of fracture is shortened and the healing rate of fracture is improved.It has a good curative effect,which is worthy of clinical promotion and application.
Objective To observe the clinical curative effect of intramedullary nail internal fixation combined with fracture bone grafting in treatment of adult patients with old femoral fracture.Methods 36 patients with old femoral fracture who were treated in our hospital from January 2015 to January 2017 were selected.Their clinical data were retrospectively analyzed.18 patients treated with intramedullary nail internal fixation were set as the control group and 18 patients treated with intramedullary nail internal fixation combined with fracture bone grafting were set as the observation group.The curative effect of operation in the two groups was compared.Results The intraoperative blood loss and postoperative drainage flow of patients in the observation group were significantly more than those in the control group(P > 0.05).The operation time in the observation group was significantly longer than that in the control group(P < 0.05).The healing rate of fractures in the observation group was significantly higher than that in the control group(P < 0.05).The healing time of fracture in the observation group was significantly shorter than that in the control group(P < 0.05).The incidence of infection,knee stiffness and loose and broken content in the observation group were all significantly higher than those in the control group(P < 0.05).And the incidence of complications in the observation group was significantly higher than that in the control group(P < 0.05).Conclusion Intramedullary nail internal fixation combined with fracture bone grafting in treatment of adult patients with old femoral fracture has a longer operation time and more intraoperative blood loss.But the incidence of complications is significantly reduced,the healing time of fracture is shortened and the healing rate of fracture is improved.It has a good curative effect,which is worthy of clinical promotion and application.
引文
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[14]张云峰,刘卫华,宋修军,等.交锁髓内钉内固定治疗陈旧性肱骨骨折并骨质疏松症[J].中国骨与关节损伤杂志,2013,28(3):276-277.
[15]郑永红,刘金榜,罗耀超,等.应用Ilizarov架牵引复位带锁髓内钉固定治疗陈旧性胫骨干骨折[J].实用骨科杂志,2015,21(2):175-177.
[16]张振南,王爱国,白玉,等.保留原钉的单皮质锁定加压钢板内固定配合植骨治疗股骨干骨折髓内钉固定术后骨折不愈合[J].中医正骨,2015,27(5):40-42.
[17]林荣华.成年患者股骨干陈旧性骨折髓内钉内固定结合断端植骨的手术效果[J].医疗装备,2018,31(14):97-98.
[18]茹江英,仓海滨,胡传亮,等.附加侧板联合植骨治疗股骨干骨折髓内钉固定后骨不连[J].中国组织工程研究,2013,17(4):604-611.
[2]于华,贾安铭.髓内钉联合植骨治疗锁定钢板内固定术后青年股骨干骨折不愈合[J].海南医学,2018,29(9):1290-1292.
[3]郑越,杨祥雷,王辉,等.自体髂骨植骨联合干细胞移植治疗早期股骨头坏死[J].中国组织工程研究,2013,23(6):4363-4370.
[4]蒋煜文,黄明光,李飞,等.多孔重建钽棒治疗早期股骨头坏死临床分析[J].岭南急诊医学杂志,2013,18(8):284.
[5]徐鸿尧,赵建宁,郭亭.纳米羟基磷灰石/聚酰胺66骨支撑材料与钽棒置入修复早期股骨头坏死:近期效果比较[J].中国组织工程研究,2014,39(9):6292-6297.
[6]林焱斌,李仁斌,张怡元,等.交锁髓内钉小切口感触辅助复位结合自体髓内取骨植骨治疗股骨干骨折[J].中华创伤骨科杂志,2012,14(3):262-264.
[7]Várady E,Feher E,Levai A,et al.Estimation of vessel age and early diagnose of atherosclerosis in progeria syndrome by using echo-tracking[J].Clin Hemorheol Microcirc,2014,44(4):297-301.
[8]Abdul-Razak,R.Muray,J.-M.Decoction in the treatment of 36 cases of apopleXy.[J]Gynecologie,obstetrique&fertilit.2013,18(2):61.
[9]E.H.Y.Cheung,A.N.Y.Law treatment of acute period o f stroke:clinical observation of 98 cases[J].Laboratory investigation,2014,14(8):21.
[10]Shingu Y,Shiiya N,Ooka T,et al.Augmentation index iselevated inaortic aneurysmanddissection[J].Ann Thorac Surg,2014,87(5):1373-1377.
[11]Kodithuwakku,S.P.Pang,R.T.K.Ng,Decoction in treating phlegmblocking collateral type stroke sequela in50 cases[J].Laboratory investigation,2013(1):31.
[12]Hoegh A,Lindholt JS.Basic science review.Vascular dis-tensibility as a predictive too l in the management of small asymptomatic abdominal aortic aneurysms[J].Vasc Endovascular Surg,2013,43(4):333-338.
[13]Guerin O,Soto ME,Brocker P,eta1.Nutritional status assessment during Alzheimer’s disease[J].J Nutr Health Aging,2012,9(2):81-84.
[14]张云峰,刘卫华,宋修军,等.交锁髓内钉内固定治疗陈旧性肱骨骨折并骨质疏松症[J].中国骨与关节损伤杂志,2013,28(3):276-277.
[15]郑永红,刘金榜,罗耀超,等.应用Ilizarov架牵引复位带锁髓内钉固定治疗陈旧性胫骨干骨折[J].实用骨科杂志,2015,21(2):175-177.
[16]张振南,王爱国,白玉,等.保留原钉的单皮质锁定加压钢板内固定配合植骨治疗股骨干骨折髓内钉固定术后骨折不愈合[J].中医正骨,2015,27(5):40-42.
[17]林荣华.成年患者股骨干陈旧性骨折髓内钉内固定结合断端植骨的手术效果[J].医疗装备,2018,31(14):97-98.
[18]茹江英,仓海滨,胡传亮,等.附加侧板联合植骨治疗股骨干骨折髓内钉固定后骨不连[J].中国组织工程研究,2013,17(4):604-611.