桥接组合式内固定和锁定加压钢板治疗股骨干粉碎性骨折的疗效比较  

Comparison of Bridge-link combined fixation and locking compression plate in the treatment of comminuted femoral fractures

作　　者：张成 张正阳 ZHANG Cheng;ZHANG Zhengyang(Department of Orthopedic 1,Jiamusi Orthopedic Hospital,Jiamusi,Heilongjiang Province,154002,China)

机构地区：[1]黑龙江省佳木斯骨科医院骨一科,154002

出　　处：《临床外科杂志》2024年第4期364-367,共4页Journal of Clinical Surgery

摘　　要：目的 比较桥接组合式内固定系统和锁定加压钢板治疗股骨干粉碎性骨折的疗效。方法 2017年1月~2021年6月收治的股骨干粉碎性骨折病人97例,其中42例实施锁定加压钢板内固定手术(钢板组),55例实施桥接组合式内固定手术(桥接组),随访至少12个月。比较两组的围手术期资料、随访资料和并发症情况。结果 钢板组和桥接组的手术时间分别为(95.37±19.31)分钟和(77.83±15.32)分钟,术中出血分别为(425.37±47.56)ml和(398.72±43.29)ml,术后引流量分别为(123.42±19.87)ml和(106.39±14.20)ml,住院时间分别为(19.31±4.26)天和(16.2 4±3.79)天,两组比较差异有统计学意义(P<0.05);术后随访1年,桥接组和钢板组的髋关节ROM分别为(132.31±15.47)°和(125.35±17.11)°、膝关节活动度ROM分别为(139.68±16.69)°和(131.49±18.24)°,两组比较差异有统计学意义(P<0.05),骨折愈合时间分别为(5.42±0.87)个月和(6.28±1.07)个月,Harris评分分别为(83.49±9.31)分和(77.57±6.39)分,HSS评分分别为(85.35±6.90)分和(80.32±7.79)分,两组比较差异有统计学意义(P<0.05)。两组切口长度和并发症比较,差异无统计学意义。结论 相比于锁定加压钢板,桥接组合式内固定治疗股骨干粉碎性骨折的手术创伤更小,骨折愈合更快,术后功能更好。Objective To compare the curative effect of bridging combined internal fixation system and locking compression plate in the treatment of comminuted femoral shaft fractures.Method The comminuted femoral shaft fractures admitted to our hospital from January 2017 to June 2021 were retrospectively analyzed.A total of 97 patients were included,of which 42 underwent internal fixation with locking compression plates(plate group),and 55 underwent internal fixation with Bridge-link combined fixation(bridge group),followed up for at least 12 months,The perioperative data,follow-up data and complications of the two groups were collected and compared.Results Compared with the plate group,the bridging group had shorter operation time[(95.37±19.31)min vs.(77.83±15.32)min],less intraoperative bleeding[(425.37±47.56)ml vs.(398.72±43.29)ml],less postoperative drainage[(123.42±19.87)ml vs.(106.39±14.20)ml],and shorter hospital stay[(19.31±4.26)d vs.(16.24±3.79)d];the one-year follow-up found that the bridging group had better hip joint and knee joint mobility[hip:(125.35±17.11)°vs.(132.31±15.47)°;knee:(131.49±18.24)°vs.(139.68±16.69)°]and faster fracture healing[(6.28±1.07)m vs.(5.42±0.87)m],and the Harris score[(77.57±6.39)vs.(83.49±9.31)]and HSS score[(80.32±7.79)vs.(85.35±6.90)]were higher than those in the steel plate group(all P<0.05).There were no significant differences in incision length and complications between the two groups(P>0.05).Conclusion Compared with locking plate,bridging combined internal fixation in the treatment of comminuted femoral shaft fractures has less surgical trauma,faster fracture healing and better postoperative function.

关 键 词：股骨干粉碎性骨折 桥接组合式内固定 锁定加压钢板 疗效对比 

分 类 号：R687.3[医药卫生—骨科学]