碳纤维外固定支架修复股骨高龄转子间骨折:生物相容性短期随访  

Carbon fiber external fixator in repair of elderly femoral intertrochanteric fracture: a short-term follow-up of biocompatibility

作　　者：李育刚[1] 

机构地区：[1]成都医学院第一附属医院骨科二区,四川省成都市610500

出　　处：《中国组织工程研究》2015年第8期1200-1205,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:外固定支架在骨折的临床治疗过程中具有很多优点,如微创技术、辐射暴露少、固定充分、闭合复位等,因此,使用外固定支架修复股骨转子间骨折可能存在一定优势。目的:探讨经皮穿针碳纤维外固定支架修复高龄转子间骨折的优势。方法:对89例高龄高风险股骨转子间骨折患者进行外固定支架治疗,均采用经皮穿针碳纤维外支架固定方案。固定后行髋关节功能锻炼,以Harris评分评价固定后1,6,12个月髋关节功能恢复情况,同时对患者置钉前后情况进行影像学评估。结果与结论:89例患者随访1至2年,1例患者因心脏病死亡。固定前患者Harris评分平均为54.3±8.3,固定后1个月达66.7±6.4,6个月时已基本恢复正常达75.5±7.3,12个月时Harris评分已达85.4±7.6,关节功能恢复良好。X射线结果显示随着骨折愈合时间的延长,髋关节功能恢复良好,2例出现钉周刺激性轻度疼痛,3例外固定钉松动、移位,6例出现针道感染,1例出现局部钉孔周围炎症反应。可见碳纤维杆外固定支架应用于老年高风险股骨转子间骨折患者固定效果确切,但仍存在钉道感染和松动等不良反应。BACKGROUND：External fixator has many advantages in treatment of fractures in the clinic, such as minimaly invasive surgical techniques, less radiation exposure, sufficient fixation and closed reduction. Therefore, external fixator for intertrochanteric fracture possibly has some advantages. OBJECTIVE：To explore the advantage of percutaneous pinning carbon fiber external fixator in repair of intertrochanteric fracture in the elderly. METHODS： A total of 89 cases of elderly patients with intertrochanteric fractures received external fixator using percutaneous pinning carbon fiber external fixation program. After fixation, al patients underwent hip joint functional exercise. The recovery of hip function was assessed using Harris score at 1, 6 and 12 months after fixation. Simultaneously, imaging evaluation was conducted before and after screw placement in patients. RESULTS AND CONCLUSION：A total of 89 patients were folowed up for 1 to 2 years. One case died due to heart disease. Harris score was 54.3±8.3 before implantation, 66.7±6.4 at 1 month after implantation, 75.5±7.3 at 6 months, and 85.4±7.6 at 12 months. The recovery of joint function was good. Radiographic results displayed that with prolonged time of healing, the hip joint function recovered wel. Two cases suffered from mild irritating pain surrounding the nail. Three cases experienced screw loosening and displacement. Six cases suffered from pin tract infection. One case had inflammation surrounding regional nail hole. These results confirmed that external fixation of carbon fiber rods in elderly patients with high risk of intertrochanteric fracture, but there are stil adverse reactions such as pin tract infection and loosing.

关 键 词：生物材料 骨生物材料 股骨转子间骨折 碳纤维 外固定支架 微创 闭合复位 骨折愈合 生物相容性 短期随访 

分 类 号：R318[医药卫生—生物医学工程]