有限接触动力加压钢板内固定植骨联合七厘散治疗四肢创伤骨折术后无菌性骨不连的效果  

Effect of limited contact dynamic compression plate internal fixation and bone grafting combined with Qili San in the treatment of aseptic nonunion after traumatic fracture of extremities

作　　者：李国德 杨远敏 曾平[3] LI Guode;YANG Yuanmin;ZENG Ping(Trauma Treatment Center,Hezhou Hospital of Traditional Chinese Medicine,Guangxi Zhuang Autonomous Region,Hezhou542800,China;Department of Trauma Orthopedics,Hezhou Hospital of Traditional Chinese Medicine,Guangxi Zhuang Autonomous Region,Hezhou542800,China;the Second Department of Orthopedics,the First Affiliated Hospital of Guangxi University of Chinese Medicine,Guangxi Zhuang Autonomous Region,Nanning530023,China)

机构地区：[1]贺州市中医医院创伤救治中心,广西贺州542800 [2]贺州市中医医院创伤骨科,广西贺州542800 [3]广西中医药大学第一附属医院骨二科,广西南宁530023

出　　处：《中国医药导报》2021年第27期84-87,共4页China Medical Herald

基　　金：广西自然科学基金面上项目(2017GXNSFAA198296)。

摘　　要：目的探讨有限接触动力加压钢板内固定植骨联合七厘散治疗四肢创伤骨折术后无菌性骨不连的效果。方法收集广西壮族自治区贺州市中医医院骨科2015年1月至2019年6月治疗的四肢创伤骨折术后无菌性骨不连患者98例为研究对象,按照随机数字表法将其分为实验组与对照组,每组各49例。两组均服用中药七厘散,实验组行有限接触动力加压钢板内固定植骨,对照组行锁定加压钢板内固定植骨。比较两组手术切口长度、手术时间、术中平均出血量、骨折愈合时间、X线骨痂评分、术后并发症发生率、胰岛素样生长因子及碱性成纤维细胞生长因子。结果实验组手术切口长度短于对照组,差异有统计学意义(P<0.05)。两组手术时间、术中平均出血量、骨折愈合时间及X线骨痂评分比较,差异无统计学意义(P>0.05);两组术后并发症发生率比较,差异无统计学意义(P>0.05);两组手术治疗后胰岛素样生长因子与碱性成纤维细胞生长因子较手术治疗前均有明显提高,差异有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05)。结论四肢创伤骨折术后无菌性骨不连患者采用有限接触动力加压钢板内固定治疗手术切口长度要短于锁定加压钢板内固定治疗,两种手术方式均可取得较好的治疗效果,且安全性较高,但有限接触动力加压钢板固定方式更微创。Objective To compare the clinical effect and safety of locking compression plate internal fixation and bone grafting combined with Qili San in patients with aseptic nonunion after the operation of limbs trauma fracture.Methods A total of 98 patients with postoperative aseptic bone nonunion from limb trauma fractures treated in Department of Orthopedics,Hezhou Hospital of Traditional Chinese Medicine from January 2015 to June 2019 were collected as the research objects.According to random number table method,they were divided into experimental group and control group,with 49 cases in each group.Both groups received Qili San,the experimental group received limited contact dynamic compression plate internal fixation and bone grafting,while the control group received locked compression plate internal fixation and bone grafting.Incision length,operative time,mean intraoperative blood loss,fracture healing time,X-ray callus score,incidence of postoperative complications,insulin-like growth factor,and basic fibroblast growth factor were compared between the two groups.Results The incision length in the experimental group was shorter than that in the control group,and the difference was statistically significant(P<0.05).There were no significant differences in operative time,average intraoperative blood loss,fracture healing time,and X-ray callus score between the two groups(P>0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).After surgical treatment,insulin-like growth factor and basic fibroblast growth factor were significantly increased in both groups compared with before surgical treatment,the difference was statistically significant(P<0.05),but there was no significant difference between groups(P>0.05).Conclusion The length of incision in patients with aseptic nonunion after operation of limbs trauma fracture is shorter than that of locking pressure plate.Both methods can achieve better therapeutic effect and safety,but the limited contact dynami

关 键 词：有限接触动力加压钢板 锁定加压钢板 四肢创伤骨折术后 无菌性骨不连 

分 类 号：R68[医药卫生—骨科学]