Fixion^TM可膨胀髓内钉系统在损伤控制骨科的初步应用  

Preliminary application of FixionTM expandable intramedullary nail system in damage control orthopedics

作　　者：易诚青[1] 曹云[1] 刘建湘[2] 陶杰[1] 李凡[1] 李豪青[1] 周孜辉[1] 左斌[1] 

机构地区：[1]上海交通大学附属第一人民医院骨科,200080 [2]华中科技大学同济医学院附属协和医院骨科

出　　处：《中华创伤杂志》2007年第4期261-264,共4页Chinese Journal of Trauma

摘　　要：目的 在损伤控制骨科（ damage control orthopedics, DCO）中初步应用Fixion^TM可膨胀髓内钉系统，与经典DCO外固定支架的临床疗效相比较，探讨Fixion^TM系统在DCO程序中的应用价值。方法 对2000年1月-2006年5月32例伴下肢长骨骨折的严重创伤患者予以分组对照研究，按术式选择分为第一组（外固定支架）、第二组（外固定支架＋有限切开内固定）与第三组（Fixion^TM可膨胀髓内钉）。比较各组术中损伤控制情况、术后监测全身情况及骨折局部随访情况。结果各组X线暴露时间差异无统计学意义，但第二组手术时间明显较长、术中失血量较多（P〈0．05）；各组术后监测指标、严重全身并发症发生率、死亡率差异亦无统计学意义；第三组局部并发症发生率、功能评分、内置物失败率均明显优于其他两组（P〈0．05）。结论 Fixion^TM系统治疗严重创伤伴下肢长骨骨折可获得与经典DCO外固定支架相近的损伤控制效果，且在局部骨折愈合与功能预后方面有明显的优势，因而在DCO程序中具有良好的应用前景。Objective To explore the clinical value of FixionTM expandable intramedullary nail system in damage control orthopedics （DCO） by comparing with classical external fixators. Methods A retrospective control analysis was done on 32 cases with multiple injury accompanied with long bone fractures in low limbs from January 2000 to May 2006. All cases were randomly divided into three groups according to different operation methods,ie, external fixators group （Group A）, external fixators with limited open internal fixations group （Group B） and FixionTM nail group （Group C）. The damage controlling during operation, the general situation after operation and local outcomes were compared between three groups. Results There were no significant differences in the X-ray exposure time, postoperative recovery time and general situation, incidence of severe complications and mortality among three groups. However, the operating time was longer and there was more hemorrhage during operation in Group B. The functional outcome was better and there were less local complications or fixation failure in Group C than in the other two groups. Conclusions Similar damage control level can be achieved by FixionTM expandable intramedullary nail system in comparison with classic external fixators in treating long bone fracture of severely injured low limbs, for FixionTM system can bring excellent functional outcome and bone union and will have favorable prospect in clinical application.

关 键 词：骨折固定术 髓内 多处创伤 损伤控制骨科 

分 类 号：R687.3[医药卫生—骨科学]