骨皮质剥脱术治疗非感染性股骨干骨不连的临床效果研究  

Study on the Clinical Effect of Bone Cortical Exfoliation in the Treatment of Non-infected Nonunion of Femur

作　　者：杨红胜[1] 贺军[1] 潘显明 曾智谋[1] 屈波 Yang Hongsheng;He Jun;Pan Xianming;Zeng Zhimou;Qu Bo(Department of Orthopaedics, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, China)

机构地区：[1]成都医学院第一附属医院骨科,成都610500

出　　处：《成都医学院学报》2020年第4期452-456,共5页Journal of Chengdu Medical College

基　　金：四川省卫生健康委员会立项项目(No:18PJ473)。

摘　　要：目的分析骨皮质剥脱术在治疗非感染性股骨干骨不连的临床疗效。方法选取2013年5月至2017年6月成都医学院第一附属医院收治的股骨干骨折术后非感染性骨不连患者28例为研究对象,按照随机数字表法分为观察组和对照组,每组14例。观察组采用骨皮质剥脱联合扩髓髓内钉及骨碎屑回植技术治疗骨不连;对照组采用植骨配合扩髓髓内钉治疗骨不连。记录并观察两组患者围手术期情况(术中出血量、手术时间、住院时间、伤口一期愈合情况等)、骨不连影像学愈合时间和愈合率。结果观察组出血量和手术时间均大于对照组,两组比较差异有统计学意义(P<0.05);两组住院时间和伤口一期愈合情况比较,差异无统计学意义(P>0.05);观察组骨不连影像学愈合时间较对照组缩短,差异有统计学意义(P<0.05);观察组骨折愈合率高于对照组,差异有统计学意义(P<0.05)。结论骨皮质剥脱术治疗非感染性股骨干骨不连效果优于单纯植骨髓内钉固定术。Objective To analyze the clinical effect of bone cortical exfoliation in the treatment of non-infected nonunion of femur.Methods Twenty-eight patients with non-infected nonunion after femoral shaft fracture surgery admitted to the First Affiliated Hospital of Chengdu Medical College from May 2013 to June 2017 were selected as the study subjects,and were divided into observation group(n=14)and control group(n=14)according to the random number table method.The observation group was treated with bone cortical denudation combined with reamed intramedullary nail and bone fragment replantation technique,while the control group was treated with bone graft combined with reamed intramedullary nail.Perioperative conditions(including intraoperative blood loss,duration of operation,hospital stay,primary wound healing,etc.),imaging healing time and healing rate of bone nonunion were recorded and observed.Results The blood loss and duration of operation in the observation group were both greater than those in the control group,and the difference between the two groups was statistically significant(P<0.05).There was no significant difference in length of hospital stay and primary wound healing between the two groups(P>0.05).The imaging healing time of bone nonunion in the observation group was shorter than that in the control group,and the difference was statistically significant(P<0.05).The fracture healing rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The effect of bone cortical exfoliation in the treatment of non-infected femoral shaft nonunion is better than that of simple intramedullary nail fixation.

关 键 词：骨皮质剥脱术 骨不连 扩髓髓内钉 植骨术 股骨骨折 

分 类 号：R687.3[医药卫生—骨科学]