带锁髓内钉和动力加压钢板内固定修复股骨干骨折后骨不连的比较  

Interlocking intramedullary nail versus dynamic compression plate fixation for nonunion after femoral shaft fracture

作　　者：宋财[1] 梁西俊[1] 刘向阳[1] 郭学德[1] 

机构地区：[1]亳州市人民医院骨三科,安徽省亳州市236800

出　　处：《中国组织工程研究》2015年第35期5663-5668,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:四肢创伤骨折后可能会出现骨不连,植入物内固定是一种常用的修复方式,但不同的植入物内固定效果不同。目的:探讨不同植入物内固定在股骨干骨折后骨不连治疗中的应用价值。方法:回顾性分析亳州市人民医院2012年11月至2013年11月收治的72例股骨干骨折后骨不连患者,按照修复方式分为观察组和对照组,每组36例,分别实施带锁髓内钉和动力加压钢板内固定治疗。观察两组患者的切口长度、术中输血量、术后引流量、手术时间、骨折愈合时间以及膝关节功能恢复情况,并进行比较分析。结果与结论:在手术时间和切口长度方面,两组差异无显著性意义(P>0.05);对照组的术中输血量和术后引流量均显著大于观察组,骨折愈合时间显著长于观察组,末次随访感染率显著高于观察组,经比较差异均有显著性意义(P均<0.05);两组治疗前国际膝关节文献委员会膝关节评估表评分和Lysholm评分经比较差异均无显著性意义(P均>0.05),但治疗后末次随访观察组的两项评分均显著高于对照组,经比较差异均有显著性意义(P均<0.05)。表明与动力加压钢板相比,应用带锁髓内钉修复股骨干骨折后骨不连可以获得更好的效果,固定牢固,感染率低,更加符合生理和生物力学要求。BACKGROUND：Bone nonunion may occur after limb trauma fracture. Internal fixation of implant is a common mode of repair, but fixation of different implants has different effects. OBJECTIVE：To explore the application value of different implant fixation in limb trauma of nonunion after femoral shaft fracture. METHODS：A retrospective analysis was performed on 72 cases of nonunion after femoral shaft fractures in Bozhou People’s Hospital from November 2012 to November 2013. They were divided into the observation group （36 cases） and control group （36 cases） according to the way of treatment, which were given interlocking intramedul ary nail and dynamic compression plate fixation. Length of incision, intraoperative blood transfusion volume, postoperative drainage volume, operation time, fracture healing time and functional recovery of knee joint were observed and compared between the two groups. RESULTS AND CONCLUSION：There was no statistical significance in operation time and length of the incision between the two groups （both P〈0.05）. Intraoperative amount of blood transfusion and postoperative drainage were significantly higher in the control group than in the observation group;the fracture healing time was significantly longer in the control group than in the observation group;infection rate in final fol ow-up wassignificantly higher in the control group than in the observation group （al P〈0.05）. No significant differences in preoperative knee joint International Knee Documentation Committee knee evaluation form and Lysholm score were found between the two groups （al P〉0.05）, but above two scores were significantly higher in the observation group than in the control group in final fol ow-up （al P〈0.05）. These findings suggest that compared with the dynamic compression plate, interlocking intramedul ary nail in treatment of bone nonunion after femoral shaft fracture can obtain good effect, firm fixation, low infection rate, and is more in line with the physiological and biom

关 键 词：植入物 骨植入物 股骨干骨折 四肢骨折 骨不连 髓内钉 动力加压钢板 骨折愈合 膝关节功能 随访研究 

分 类 号：R318[医药卫生—生物医学工程]