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 bone nonunion after traumatic fracture of extremities and its influence on limb movement

作　　者：闫孝明 纪方成 仙跃华 YAN Xiao-ming;JI Fang-cheng;XIAN Yue-hua(Jining Rencheng District People's Hospital,Jining 272007,China)

机构地区：[1]济宁市任城区人民医院,272007

出　　处：《中国现代药物应用》2023年第16期60-63,共4页Chinese Journal of Modern Drug Application

摘　　要：目的分析四肢创伤性骨折后骨不连患者应用带锁髓内钉固定术的效果。方法40例四肢创伤性骨折后骨不连患者作为研究对象,根据治疗方法的不同分为对照组及观察组,每组20例。对照组应用加压钢板内固定术治疗,观察组应用带锁髓内钉固定术治疗。对比两组患者的骨折愈合优良率,手术指标[手术时间、骨折愈合时间、住院时间、术后2周视觉疼痛模拟评分法(VAS)评分],术前和术后1个月的骨代谢指标[碱性磷酸酶(ALP)、骨保护素(OPG)、骨钙素(BGP)、表皮生长因子(EGF)],术后1、3个月的四肢功能情况[骨折愈合评分系统(RUSS)、Lane-Sandhu评分、四肢活动评分]。结果观察组患者的骨折愈合优良率95.00%高于对照组的70.00%,差异具有统计学意义(P<0.05)。观察组患者的手术时间(124.79±14.84)min、骨折愈合时间(21.67±2.55)周、住院时间(10.87±2.57)d均短于对照组的(142.87±16.52)min、(30.52±4.15)周、(14.22±3.82)d,术后2周VAS评分(2.56±0.70)分低于对照组的(3.26±0.85)分,差异具有统计学意义(P<0.05)。术后1个月,观察组患者的ALP(162.54±11.52)mmol/L、OPG(4.65±0.38)μg/L、BGP(60.05±6.27)ng/L、EGF(0.96±0.14)pg/ml均高于对照组的(144.22±9.92)mmol/L、(3.26±0.32)μg/L、(52.42±6.05)ng/L、(0.85±0.10)pg/ml,差异具有统计学意义(P<0.05)。观察组患者术后1个月的RUSS评分、Lane-Sandhu评分、四肢活动评分分别为(4.68±0.64)、(3.08±0.52)、(80.22±7.04)分,术后3个月的RUSS评分、Lane-Sandhu评分、四肢活动评分分别为(7.62±0.28)、(6.82±1.38)、(88.68±7.29)分,均高于对照组术后1个月的(3.52±0.55)、(2.12±0.42)、(74.94±6.82)分及术后3个月的(6.25±0.42)、(4.65±1.32)、(82.56±7.15)分,差异具有统计学意义(P<0.05)。结论四肢创伤性骨折后骨不连患者应用带锁髓内钉固定术治疗效果良好,可以有效加快患者的骨折愈合速度,有利于改善患者预后,值得临床推广应用。Objective To analyze the effect of interlocking intramedullary nail fixation in the treatment of bone nonunion after traumatic fracture of extremities.Methods A total of 40 patients with bone nonunion after traumatic fracture of the extremities were studied,and they were divided into control group and observation group according to the different treatment methods,with 20 cases in each group.The control group was treated with compression plate internal fixation,and the observation group was treated with interlocking intramedullary nail fixation.Both groups were compared in terms of excellent fracture healing rate,surgical indexes[operative time,fracture healing time,hospital stay,visual analogue scale(VAS)score at 2 weeks after surgery],bone metabolic indexes[alkaline phosphatase(ALP),osteoprotegerin(OPG),osteocalcin(BGP),epidermal growth factor(EGF)]before and 1 month after surgery,and limb function[radius union scoring system(RUSS),LaneSandhu score,and limb movement score]at 1 and 3 months after surgery.Results The excellent fracture healing rate of 95.00%in the observation group was higher than that of 70.00%in the control group,and the difference was statistically significant(P<0.05).In the observation group,the operative time was(124.79±14.84)min,the fracture healing time was(21.67±2.55)weeks and the hospital stay was(10.87±2.57)d,which were shorter than those of(142.87±16.52)min,(30.52±4.15)weeks and(14.22±3.82)d in the control group;VAS score of(2.56±0.70)points at 2 weeks after surgery in the observation group was lower than that of(3.26±0.85)points in the control group;the differences were statistically significant(P<0.05).At 1 month after surgery,the observation group had ALP of(162.54±11.52)mmol/L,OPG of(4.65±0.38)μg/L,BGP of(60.05±6.27)ng/L,and EGF of(0.96±0.14)pg/ml,which were higher than those of(144.22±9.92)mmol/L,(3.26±0.32)μg/L,(52.42±6.05)ng/L,and(0.85±0.10)pg/ml in the control group,and the differences were statistically significant(P<0.05).In the observation group,RUSS score,L

关 键 词：四肢创伤性骨折后骨不连 带锁髓内钉固定术 治疗效果 

分 类 号：R687.3[医药卫生—骨科学]