带锁髓内钉固定术治疗四肢创伤性骨折后骨不连的临床效果及对四肢活动情况的影响  

Clinical effect of interlocking intramedullary nail fixation in the treatment of nonunion after traumatic fracture of extremities and its influence on limb movement

作　　者：李智伟 刘宏建[2] LI Zhiwei;LIU Hongjian(No.2 Trauma Orthopedics Department,Ruzhou Orthopedics Hospital,Pingdingshan 467599;Orthopedics Department,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]汝州市骨科医院创伤骨科二科,河南平顶山467599 [2]郑州大学第一附属医院骨科,河南郑州450052

出　　处：《临床医学研究与实践》2022年第24期62-64,共3页Clinical Research and Practice

摘　　要：目的 探讨带锁髓内钉固定术治疗四肢创伤性骨折后骨不连的临床效果及对四肢活动情况的影响。方法 将我院收治的80例四肢创伤性骨折后骨不连患者随机分为对照组(40例,加压钢板内固定术)和观察组(40例,带锁髓内钉固定术)。比较两组患者的骨折愈合优良率、手术相关指标、骨代谢指标及四肢功能。结果 观察组的骨折愈合优良率高于对照组(P<0.05)。观察组的手术时间、骨折愈合时间、住院时间均短于对照组,术后2周视觉模拟评分法(VAS)评分低于对照组(P<0.05)。术后1个月,两组的碱性磷酸酶(ALP)、骨保护素(OPG)、骨钙素(BGP)、表皮生长因子(EGF)水平均升高,且观察组高于对照组(P<0.05)。术后1、3个月,观察组的Radius联合评分系统(RUSS)、Lane-Sandhu评分及四肢活动评分均高于对照组(P<0.05)。结论 带锁髓内钉固定术治疗四肢创伤性骨折后骨不连的临床效果显著,可有效提升骨代谢指标水平,促进早期骨痂形成和骨折愈合,改善四肢活动功能。Objective To explore the clinical effect of interlocking intramedullary nail fixation in the treatment of nonunion after traumatic fracture of extremities and its influence on limb movement.Methods A total of 80 patients with nonunion after traumatic fracture of extremities treated in our hospital were randomly divided into control group(40 cases,internal fixation with compression plate) and observation group(40 cases,interlocking intramedullary nail fixation).The excellent and good rate of fracture healing,operation related indexes,bone metabolism indexes and limb function were compared between the two groups.Results The excellent and good rate of fracture healing in the observation group was higher than that in the control group(P<0.05).The operation time,fracture healing time and hospital stay in the observation group were shorter than those in the control group,and the Visual Analogue Scale(VAS) score of the two weeks after operation was lower than that in the control group(P<0.05).One month after operation,the levels of alkaline phosphatase(ALP),osteoprotegerin(OPG),bone gla protein(BGP) and epidermal growth factor(EGF) in the two groups increased,and those in the observation group were higher than the control group(P<0.05).At 1 and 3 months after operation,the scores of Radius Union Scoring System(RUSS),Lane-Sandhu and limb movement in the observation group were higher than those in the control group(P <0.05).Conclusion Interlocking intramedullary nail fixation in the treatment of nonunion after traumatic fracture of extremities has a significant clinical effect,it can effectively improve the levels of bone metabolism indexes,promote early callus formation and fracture healing,and ameliorate the extremity motor function.

关 键 词：四肢创伤性骨折 骨不连 带锁髓内钉固定术 骨代谢指标 

分 类 号：R730.55[医药卫生—肿瘤]