带锁髓内钉治疗四肢创伤骨折后骨不连的疗效评价
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摘要
目的:探讨带锁髓内钉治疗四肢创伤骨折后骨不连的临床疗效。方法:将48例四肢创伤性骨折后骨不连患者按照患者按意愿分为对照组(n=20)与观察组(n=28),对照组接受加压钢板固定治疗,观察组接受带锁髓内钉固定治疗;比较两组的手术情况,术后随访半年,比较两组术后恢复情况。结果:观察组手术时间、术中输血量及术后引流量均明显优于对照组(P <0. 05);两组治疗总有效率差异无统计学意义(P> 0. 05),但观察组治疗效果优秀、良好的例数较多;两组并发症发生率差异无统计学意义(P> 0. 05),但观察组未出现再骨折现象。结论:对于四肢创伤骨折后骨不连患者,使用带锁髓内钉加以固定疗效显著,值得临床推广使用。
Objective: To explore the efficacy of interlocking intramedullary nail in the treatment of bone nonunion after traumatic fracture of limbs. Methods: Totally 48 patients with bone nonunion after traumatic fracture of limbs were divided into control group( n = 20) and observation group( n = 28) according to their wills. The patients in control group were fixed by the compression plate,while those in observation group by interlocking intramedullary nail. The operation condition of both groups was compared. The follow-up visit lasted 6 months,and the postoperative recovery condition was observed between two groups. Results: The operation time,intra-operative amount of blood transfusion and postoperative volume of drainage in observation group were superior to those in control group( P <0. 05). There was no statistical significance between two groups regarding the overall response rates( P > 0. 05),but the number of patients with excellent and good effect in observation group were more. There was no statistical significance between two groups regarding the incidence of complications( P > 0. 05),but no fracture occurred in observation group again. Conclusion: For the patients with bone nonunion after traumatic fracture of limbs,interlocking intramedullary nail for the fixation has good effect,so it is worthy of popularization and application in clinic.
Objective: To explore the efficacy of interlocking intramedullary nail in the treatment of bone nonunion after traumatic fracture of limbs. Methods: Totally 48 patients with bone nonunion after traumatic fracture of limbs were divided into control group( n = 20) and observation group( n = 28) according to their wills. The patients in control group were fixed by the compression plate,while those in observation group by interlocking intramedullary nail. The operation condition of both groups was compared. The follow-up visit lasted 6 months,and the postoperative recovery condition was observed between two groups. Results: The operation time,intra-operative amount of blood transfusion and postoperative volume of drainage in observation group were superior to those in control group( P <0. 05). There was no statistical significance between two groups regarding the overall response rates( P > 0. 05),but the number of patients with excellent and good effect in observation group were more. There was no statistical significance between two groups regarding the incidence of complications( P > 0. 05),but no fracture occurred in observation group again. Conclusion: For the patients with bone nonunion after traumatic fracture of limbs,interlocking intramedullary nail for the fixation has good effect,so it is worthy of popularization and application in clinic.
引文
[1]宋财,梁西俊,刘向阳,等.带锁髓内钉和动力加压钢板内固定修复股骨骨折后骨不连的比较[J].中国组织工程研究,2015,19(35):5663-5668.
[2]熊庆广,王永清,张庆杰,等.多向带锁髓内钉治疗胫骨pilon骨折的疗效分析[J].中华骨科杂志,2015,35(7):720-726.
[3]乔俊,陈天健,朴杰.带锁髓内钉固定加植骨术治疗胫骨骨折骨不连[J].川北医学院学报,2007,22(5):471-473.
[4]睢更义,张同润,刘玉波,等.带锁髓内钉治疗股骨中下段骨折术后骨不连的临床效果[J].临床军医杂志,2015,43(1):89-90.
[5]孙效虎,袁景.锁定钢板联合带锁髓内钉治疗胫骨多段骨折[J].临床骨科杂志,2016,19(1):126.
[6]王泉,吴占坡,董桂贤,等.闭合复位带锁髓内钉结合负压封闭引流治疗开放性胫骨骨折疗效分析[J].河北医科大学学报,2015,36(10):1153-1154,1165.
[7]邹平洲,杨发民,付士平.双钢板内固定治疗下肢骨干骨折术后骨不连[J].中国骨与关节损伤杂志,2015,30(4):440-441.
[8]洪帆,谢加兵,丁国正.内固定植入物与外固定支架修复胫骨骨折骨不连的策略及辅助治疗[J].中国组织工程研究,2016,20(26):3946-3952.
[9]杨朝旭,刘建恒,张里程,等.两种手术治疗股骨干骨折后骨不连的疗效分析[J].解放军医学院学报,2016,37(1):24-26.
[10]周潇逸,李付琦,唐昊,等.骨不连的生物学研究现状及治疗进展[J].中国矫形外科杂志,2015,23(22):2075-2078.
[11]丁文义,安小刚,倪金和,等.四肢骨折术后骨不连的治疗策略及相关问题分析[J].中国骨与关节损伤杂志,2015,30(12):1338-1340.
[12]张振中,侯瑞青,沈静,等.带锁髓内钉在新鲜四肢长骨干骨折治疗中的应用[J].河北医学,2016,22(4):625-627.
[13]牛志霞,苏健,张延琴,等.下肢骨干骨折髓内钉内固定术后感染性骨不连的治疗体会[J].中国骨与关节损伤杂志,2015,30(10):1102-1103.
[2]熊庆广,王永清,张庆杰,等.多向带锁髓内钉治疗胫骨pilon骨折的疗效分析[J].中华骨科杂志,2015,35(7):720-726.
[3]乔俊,陈天健,朴杰.带锁髓内钉固定加植骨术治疗胫骨骨折骨不连[J].川北医学院学报,2007,22(5):471-473.
[4]睢更义,张同润,刘玉波,等.带锁髓内钉治疗股骨中下段骨折术后骨不连的临床效果[J].临床军医杂志,2015,43(1):89-90.
[5]孙效虎,袁景.锁定钢板联合带锁髓内钉治疗胫骨多段骨折[J].临床骨科杂志,2016,19(1):126.
[6]王泉,吴占坡,董桂贤,等.闭合复位带锁髓内钉结合负压封闭引流治疗开放性胫骨骨折疗效分析[J].河北医科大学学报,2015,36(10):1153-1154,1165.
[7]邹平洲,杨发民,付士平.双钢板内固定治疗下肢骨干骨折术后骨不连[J].中国骨与关节损伤杂志,2015,30(4):440-441.
[8]洪帆,谢加兵,丁国正.内固定植入物与外固定支架修复胫骨骨折骨不连的策略及辅助治疗[J].中国组织工程研究,2016,20(26):3946-3952.
[9]杨朝旭,刘建恒,张里程,等.两种手术治疗股骨干骨折后骨不连的疗效分析[J].解放军医学院学报,2016,37(1):24-26.
[10]周潇逸,李付琦,唐昊,等.骨不连的生物学研究现状及治疗进展[J].中国矫形外科杂志,2015,23(22):2075-2078.
[11]丁文义,安小刚,倪金和,等.四肢骨折术后骨不连的治疗策略及相关问题分析[J].中国骨与关节损伤杂志,2015,30(12):1338-1340.
[12]张振中,侯瑞青,沈静,等.带锁髓内钉在新鲜四肢长骨干骨折治疗中的应用[J].河北医学,2016,22(4):625-627.
[13]牛志霞,苏健,张延琴,等.下肢骨干骨折髓内钉内固定术后感染性骨不连的治疗体会[J].中国骨与关节损伤杂志,2015,30(10):1102-1103.