桥接系统治疗股骨干节段性骨折的临床观察  

Clinical observation on treatment of segmental fracture of femoral shaft by bridge system

作　　者：黄飞[1] 赖爱宁[1] 于凤宾[1] 朱新宏[1] 陶德刚[1] 郭龙[1] 陈冰[1] HUANG Fei;LAI Ai-ning;YU Feng-bin(Dept of 2nd Orthopaedics,The 98th Hospital of PLA,Zhejiang Huzhou 313000)

机构地区：[1]解放军第98医院骨二科,浙江湖州313000

出　　处：《中国伤残医学》2018年第22期1-3,共3页Chinese Journal of Trauma and Disability Medicine

基　　金：国家卫生计生委科技发展中心课题(W2015qj042).

摘　　要：目的:探讨股骨干节段性粉碎性骨折利用桥接系统内固定术手术效果.方法:回顾性分析我院2014年1月-2017年2月间,利用桥接系统原理,以钉棒块组合结构克服应力集中应力遮挡,以弹性固定代替刚性固定,以非接触和动力性组配固定实现更好的生物力学性能和生物学效应的桥接系统内固定术,对节段、粉碎性骨折行内固定治疗的患者72例.结果:72例病人,骨不连患者4例,骨关节僵硬3例,其余无钢板断裂及骨感染等不良结果.功能结果,疗效判定标准,采用Friedman-Vyman系统评价患者治疗效果,分别为优、良、一般和差4个等级.优良率=(优+良)/总例数×100%,优42例,良18,可10,差2,优良率83.3%.结论:桥接系统(1)通过多向置钉实现'三维固定',有效提高抗拔出强度;(2)通过轴向滑动获得'中心固定'效应,有利避免应力遮挡;(3)通过'动力加压'模式,产生骨折断端3D应力,有效促进骨折愈合;(4)通过多节段和跳跃置钉实现'桥接固定'和'弹性固定'模式,维持断端持续应力和微动,有益刺激骨痂生长等.在治疗严重粉碎性骨折、多段性骨折、骨质疏松性骨折方面,应用该系统可任意组配及塑形的优势,解决了常规和传统方法所无法解决的问题.Objective:To explore the effect of the fixation operation of femoral shaft segmental comminuted fracture with bridging system.Methods:A retrospective analysis of our hospital between January 2014 and February 2014,using the bridge system principle,in order to nail stick piece of composite structure to overcome the stress concentration stress shelter,replace the rigid fixation with elastic fixed,non-contact and dynamic equipping fixed achieve better biomechanical properties and the biological effect of bridge system and internal fixation,to segment and fixed treatment of 72 cases of patients with comminuted fractures of the same industry.Results:There were 72 patients,4 patients with bone nonunion,3 cases of bone joint stiffness,and no other adverse outcomes such as plate fracture and bone infection.Functional results,efficacy criteria,and Friedman-Vyman system was used to evaluate the therapeutic effect of patients,respectively,with four grades of excellent,good,general and poor.Good rate=(excellent+good)/total number of cases X 100%,excellent 42,good 18,but 10,difference 2.Conclusion:The bridge system could achieve"three-dimensional fixation"through the multi-direction pin,which could effectively improve the tensile strength.The"center fixed"effect was obtained through axial sliding,which was advantageous to avoid the stress occlusion.Through"dynamic pressure"mode,the 3D stress of fracture ends was generated,which effectively promoted fracture healing.The"bridge fixation"and"elastic fixation"mode were achieved through multi-segment and jumping jacks to maintain the continuous stress and micro-motion of the broken end,which was beneficial to stimulate the growth of callus.In the treatment of serious comminuted fracture,fracture,osteoporosis fracture,the application could be arbitrary equipping shape and the advantages of the system,to solve the problems could not be solved by the conventional and traditional methods.

关 键 词：骨折 桥接系统 手术治疗 

分 类 号：R683.42[医药卫生—骨科学]