天鹅记忆接骨器与接骨板和髓内针治疗肱骨干骨折的比较研究  

Comparative study of swan-like memory connector versus dynamic compressive plate and locked intramedullary nail in treating humeral fractures

作　　者：康庆林[1] 张春才[1] 许硕贵[1] 高堂成[1] 任可[1] 

机构地区：[1]第二军医大学长海医院骨科,上海200433

出　　处：《第四军医大学学报》2003年第18期1713-1716,共4页Journal of the Fourth Military Medical University

基　　金：第二军医大学长海医院"2 58"基金 (2 0 0 2 2 580 6)

摘　　要：目的 :对天鹅记忆接骨器 (swan likememoryconnec tor,SMC)和加压接骨板 (dgnanciccompressiveplate,DCP)以及带锁髓内针 (lockedintramedullaynail,LIN)治疗肱骨干骨折的疗效进行前瞻性临床对比研究 .方法 :随机选择 1995 0 1/2 0 0 1 12入院的新鲜股骨干骨折 32 1例 ,分别采用SMC与DCP ,LIN进行内固定治疗 ,术后常规抗炎治疗 1wk ,不用外固定 ,定期拍片并随访患肢功能恢复情况 .结果 :SMC组的手术时间 (h)明显短于DCP组与LIN组 (1.8± 0 .7vs 2 .5±0 .5& 2 .8± 0 .8,P <0 .0 5 ) ,而住院费用 ($)也显著少于DCP组和LIN组 (6 2 6 5± 76 0vs 80 34± 986& 976 7± 82 9,P<0 .0 5 ) ,3组在伤口感染和合并桡神经损伤方面无差异 .SMC组骨愈合时间 (wk)显著短于DCP组和LIN组 (12 .5±4 .6vs 17.1± 4 .9& 16 .8± 6 .1,P <0 .0 5 ) ,而术后功能优良率高于DCP组和LIN组 .在天鹅接骨器固定下 ,骨折愈合直接由板层骨直接替代连接 ,固定段无应力遮挡和骨质疏松 .结论 :SMC的几何构形和力学特性有利于骨折愈合 .在本器固定下 。AIM: To compare the curative effects of swan like memory connector (SMC) versus dynamic compressive plate (DCP) and locked intramedullary nail (LIN) in treating humeral fractures. METHODS: From January 1995 to December 2001, 321 cases of humeral fracture were randomized into 3 groups: 103 cases were stabilized with SMC, 111 cases DCP and 107 cases LIN. After operation, no external fixation was employed in the treated limbs and the fracture healing was followed up regularly using radiography. RESULTS: The operative duration(hour) in SMC group was significantly shorter than those in DCP and LIN groups (1.8±0.7 vs 2.5±0.5 & 2.8±0.8, P <0.05), the hospital cost ($) in SMC group also was significantly less than those in DCP and LIN groups (6265±760 vs 8034±986 & 9767±829, P <0.05). The fracture healing time(week) in SMC group was significantly shorter than those of DCP and LIN groups (12.5±4.6 vs 17.1±4.9 & 16.8±6.1, P <0.05). The results in SMC group were superior to those in DCP and LIN groups. Neither external callus nor osteoporosis beneath the SMC body was found in SMC group. CONCLUSION: SMC, with its mechanical properties and geometric contour, provides a favorable mechanical field for fracture healing. There is probably a new fracture healing style using SMC fixation.

关 键 词：骨折固定术 骨折愈合 天鹅记忆接骨器 加压接骨板 交锁髓内针 治疗结果 形状记忆合金 

分 类 号：R683.2[医药卫生—骨科学]