关节镜微创手术股骨骨折愈后内固定材料取出的临床疗效  

Clinical effect of removal of internal fixation materials percutaneously under arthroscopy after healing from femoral fractures

作　　者：杨良锁 彭高峰 郭小奇 李晓文 何江涛 

机构地区：[1]舞阳县人民医院骨病科,河南漯河462400 [2]漯河市骨科医院关节外科

出　　处：《包头医学院学报》2017年第9期20-21,42,共3页Journal of Baotou Medical College

摘　　要：目的:探讨股骨骨折愈合后在关节镜监视下经皮取出内固定材料的临床疗效。方法:选取2013年5月至2016年5月收治的82例股骨骨折钢板螺钉内固定术骨折愈合后需要取出内固定材料的患者,分为关节镜组(32例)与常规手术组(50例),关节镜组在关节镜监视下经皮取出内固定材料,常规组按原手术切口切开取出内固定材料,比较两组患者的切口长度、手术时间、手术出血量、住院时间、术后疼痛视觉模拟评分法(visual analogue scale/score,VAS)评分情况。结果:关节镜组较常规组手术切口小(Z=5.431,P=0.000),手术出血少(Z=5.365,P=0.000),住院时间短(t=4.091,P=0.000),术后VAS评分较常规手术组降低(t=4.872,P=0.000);两组手术时间比较差异无统计学意义(P>0.05)。结论:股骨骨折愈合后在关节镜监视下经皮取出内固定材料,创伤小、出血少,临床效果好,患者满意,临床中已具备关节镜手术条件的单位可以推广开展。Objective： To explore the clinical effect of removal of internal fixation materials percutaneously under arthroscopy after healing from femoral fractures.Methods： The clinical data of 82 patients with femoral fractures treated with internal fixation with steel plate and screw fixation hospitalized from May 2013 to May 2016,whose internal fixation materials needed to be removed were retrospectively analyzed and divided into the arthroscopy group（ 32 cases） and the conventional surgery group（ 50 cases）. The arthroscopy group received percutaneous removal of the internal fixation materials under arthroscopy,while the conventional group received removal of the internal fixation materials via the original incision,with the incision length,the operation time,the amount of bleeding,the hospitalization time and the postoperative pain visual analogue scale（ VAS） compared. Results： The operative incision of the arthroscopy group was smaller than that of the conventional group（ Z= 5. 431,P = 0. 000）; the amount of bleeding during operation in the arthroscopy group was less than that in the conventional group（ Z = 5. 365,P = 0. 000）; the length of hospital stay was shorter in the arthroscopy group than that in the conventional group（ t = 4. 091,P = 0. 000）; the postoperative VAS score in the arthroscopy group was lower than that in the conventional operation group（ t = 4. 872,P = 0. 000）. There was no statistical difference between the two groups in the operation time（ P 〉 0. 05）. Conclusion： Removal of internal fixation materials percutaneously under arthroscopy after healing from femoral fractures is less traumatic and has less bleeding and a good clinical effect,with which the patients are satisfied,so it can be promoted in the hospitals which were equipped with arthroscopy.

关 键 词：关节镜 股骨 术后 内固定取出 微创 

分 类 号：R687.3[医药卫生—骨科学]