两种内固定治疗腕关节结核的疗效比较  

Comparison efficacy of two kinds of internal fixation for treatment of wrist tuberculosis

作　　者：窦吉辰 鲁宁[2] 刘思源 赵衡 饶涛 周奕 郑刚 寸新华 DOU Ji-chen;LU Ning;LIU Si-yuan;ZHAO Heng;RAO Tao;ZHOU Yi;ZHENG Gang;CUN Xin-hua(Dept of Orthopaedics,the Third People′s Hospital of Kunming,Kunming,Yunnan 650041,China)

机构地区：[1]昆明市第三人民医院骨科,云南昆明650041 [2]昆明医科大学第二附属医院骨科,云南昆明650106

出　　处：《临床骨科杂志》2024年第3期336-340,共5页Journal of Clinical Orthopaedics

基　　金：云南省教育厅科学研究基金(编号:2019J0789)。

摘　　要：目的比较桥接组合式内固定和锁定钛板内固定治疗腕关节结核的疗效。方法将24例腕关节结核患者根据内固定方式不同分为钛板组(采用锁定钛板内固定治疗,13例)和桥接组(采用桥接组合式内固定治疗,11例)。比较两组手术时间、术中出血量、关节融合时间、并发症、Buck-Gramcko/Lohmannn评分、疼痛VAS评分、上肢功能障碍评定量表(DASH)评分。结果患者均获得随访,时间18~36个月。手术时间、术中出血量、关节融合时间桥接组均短(少)于钛板组(P<0.05)。术后18个月手功能Buck-Gramcko/Lohmannn评分、疼痛VAS评分、DASH评分两组比较差异均无统计学意义(P>0.05)。两组并发症发生率比较差异无统计学意义(P>0.05)。结论与锁定钛板相比,桥接组合式内固定治疗腕关节结核术中出血量少,手术时间短,关节融合时间短。Objective To compare the efficacy of bridge combined internal fixation and locking titanium plate in the treatment of wrist tuberculosis.Methods According to different internal fixation methods,24 patients with wrist tuberculosis were divided into titanium plate group(locking titanium plate internal fixation treatment,13 cases)and bridge group(bridging combined internal fixation treatment,11 cases).The operative time,intraoperative blood loss,joint fusion time,complications,and Buck-Gramcko/Lohmannn score,pain VAS and disabilities of the arm,shoulder and hand(DASH)score were compared between the two groups.Results All patients were followed up for 18~36 months.Operation time,intraoperative blood loss and joint fusion time in bridge group were all shorter(less)than those in titanium plate group(P<0.05).At 18 months after surgery,there were no statistical differences in Buck-Gramcko/Lohmannn scores of the hand function,pain VAS and DASH scores between the two groups(P>0.05).There was no statistical difference in complication incidence rate between the two groups(P>0.05).Conclusions Compared with the locking titanium plate,the bridge combined internal fixation has less blood loss,shorter operation time,and shorter joint fusion time in the treatment of wrist tuberculosis.

关 键 词：腕关节结核 关节融合 桥接组合式内固定 

分 类 号：R529.2[医药卫生—内科学] R687.3[医药卫生—临床医学] R687.4