双钢板垂直固定联合髂骨植骨治疗四肢骨不连回顾性分析  

Retrospective analysis of treatment of nonunion of extremities with double-plate vertical fixation combined with iliac bone grafting

作　　者：王化齐[1] 韩晓强[1] 党杰[1] 董博 袁普卫 欧国峰[3] 王国柱[3] 刘德玉 WANG Huaqi;HAN Xiaoqiang;DANG Jie(Department of Orthopaedics,Ankang Hospital of Traditional Chinese Medicine,Ankang 725000)

机构地区：[1]陕西省安康市中医医院骨科,安康725000 [2]陕西中医药大学附属医院骨病科,咸阳712000 [3]陕西中医药大学第二附属医院外一科,咸阳712000

出　　处：《陕西医学杂志》2020年第6期704-707,712,共5页Shaanxi Medical Journal

基　　金：陕西省重点科技创新团队项目(2013KJT-26);全国名老中医药专家传承工作室建设项目(国中医药人教发[2018]134号);关中李氏骨伤流派传承工作室项目(陕中医药发[2018]40号)。

摘　　要：目的:分析双钢板垂直固定联合髂骨植骨治疗四肢骨不连的临床疗效及患者的远期生活质量。方法:筛选可沟通、语言表达清晰、主动配合的行双钢板垂直固定联合髂骨植骨治疗四肢骨不连的患者47例进行随访并填写SF-36健康调查量表,同时将其与健康人对比分析其远期生活质量。结果:所有患者均获6~15个月随访[平均(11.30±2.01)个月],治愈率为100%,骨折愈合时间3~13个月[平均(7.8±1.79)个月],2例发生术后钢板断裂,经二期重复双钢板垂直固定均已达到临床骨愈合标准;对患者骨愈合进行评估,优45例,良2例,优良率为100%;对患者肢体功能评估,优42例,良5例,优良率为100%。SF-36健康调查量表健康人群中各项得分均高于观察组(P<0.05),经Spearman相关性分析发现患者生理功能与部位呈正相关,情感职能评分与职业呈正相关、与性别呈负相关,而精神健康评分与职业正相关,相关性并不密切。结论:双钢板垂直固定联合髂骨植骨治疗四肢骨不连的治愈率高,患者肢体功能恢复良好,但愈合时间较长,其远期生活质量与健康人相比有所下降,其一般健康状况评分与部位和初次固定方式呈正相关,因此选择合适的手术方式能促进患者肢体功能的恢复,提高患者远期生活质量。Objective:To analysis the clinical efficacy of double-plate vertical fixation combined with iliac bone grafting in the treatment of nonunion of the extremities and the long-term quality of life of patients.Methods:47 patients with good communication,clear language expression and active cooperation who were treated with double-plate vertical fixation combined with iliac bone grafting for nonunion of the extremities were followed up and filled in the SF-36 health survey scale,and their long-term quality of life was compared with that of healthy people.Results:All patients were followed up for 6 to 15 months(mean 11.30±2.01 months).The cure rate was 100%.The fracture healing time was 3 to 13 months(mean 7.8±1.79 months).2 cases had postoperative plate fracture,and reached the standard of clinical bone healing after repeated double-plate vertical fixation.The evaluation of bone healing in patients was excellent in 45 cases and good in 2 cases,the excellent and good rate was 100%.The evaluation of limb function was excellent in 42 cases and good in 5 cases,the excellent and good rate was 100%.The scores of healthy people in the SF-36 health survey scale were higher than those in the observation group(P<0.05).The Spearman correlation analysis found that the physiological function of the patients was positively correlated with the location,and the emotional function score was positively correlated with the occupation,and negatively correlated with gender.The mental health score was positively correlated with the occupation,but the correlation was not close.Conclusion:The double-plate vertical fixation combined with the iliac bone grafting has a high cure rate in the treatment of nonunion of the extremities.The limb function recovery is good,but the healing time is longer.The long-term quality of life is lower than that of healthy people.The general health status score is positively correlated with the site and the initial fixation.Therefore,the selection of appropriate surgical methods can promote the recovery of limb

关 键 词：双钢板垂直固定 髂骨植骨 股骨干骨折 肱骨干骨折 骨不连 SF-36健康调查量表 

分 类 号：R681[医药卫生—骨科学]