带锁髓内钉内固定术与动力加压钢板内固定术治疗四肢骨折术后骨不连患者的效果比较  

Comparison of effects of interlocking intramedullary nail internal fixation and dynamic compression plate internal fixation in treatment of patients with bone nonunion after limb fracture surgery

作　　者：陈凡州 张岐 CHEN Fanzhou;ZHANG Qi(1^(st) Department of Orthopaedics of the Third Affiliated Hospital of Nanyang Medical College,Nanyang 473000 Henan,China;1^(st) Department of Orthopaedics of Nanzhao Hongyu Hospital,Nanyang 473000 Henan,China)

机构地区：[1]南阳医学高等专科学校第三附属医院骨一科,河南南阳473000 [2]南召红宇医院骨一科,河南南阳473000

出　　处：《中国民康医学》2024年第22期141-144,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较带锁髓内钉内固定术与动力加压钢板内固定术治疗四肢骨折术后骨不连患者的效果。方法:选取2021年1月至2023年9月南阳医学高等专科学校第三附属医院收治的80例四肢骨折术后骨不连患者进行前瞻性研究,按照随机数字表法将其分为对照组与观察组各40例。对照组采用动力加压钢板内固定术治疗,观察组采用带锁髓内钉内固定术治疗,比较两组手术优良率,围术期指标(手术时间、术中出血量、术后引流量、术后住院时间)水平,手术前后骨代谢指标[骨特异性碱性磷酸酶(BALP)、Ⅰ型前胶原氨基端前肽(PⅠNP)、骨钙素(BGP)]水平、肢体运动功能[Fugl-Meyer运动功能评定量表(FMA)]评分、日常生活能力[日常生活活动能力量表(ADL)]评分,以及并发症发生率。结果:观察组手术优良率为92.50%(37/40),高于对照组的70.00%(28/40),差异有统计学意义(P<0.05);观察组手术时间、术后住院时间均短于对照组,术中出血量、术后引流量均少于对照组,差异有统计学意义(P<0.05);术后,观察组BALP、PⅠNP、BGP水平均高于对照组,差异有统计学意义(P<0.05);术后,观察组FMA、ADL评分均高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为12.50%(5/40),低于对照组的35.00%(14/40),差异有统计学意义(P<0.05)。结论:带锁髓内钉内固定术治疗四肢骨折术后骨不连患者可提高手术优良率、骨代谢指标水平和肢体运动功能、日常生活能力评分,改善围术期指标水平,降低并发症发生率,效果优于动力加压钢板内固定术治疗。Objective:To compare effects of interlocking intramedullary nail internalfixation and dynamic compression plate internalfixation in treatment of patients with bone nonunion after limb fracture surgery.Methods:A prospective study was conducted on 80 patients with bone nonunion after limb fracture surgery admitted to Third Affiliated Hospital of Nanyang Medical College from January 2021 to September 2023.According to the random number table method,they were divided into control group and observation group,40 cases in each group.The control group was treated with dynamic compression plate internalfixation,while the observation group was treated with interlocking intramedullary nail internalfixation.The excellent and good rate of operation,the levels of perioperative indexes(operation time,intraoperative blood loss,postoperative drainage volume,postoperative hospitalization time)and bone metabolism indexes[bone specific alkaline phosphatase(BALP),type I procollagen amino terminal propeptide(PINP),osteocalcin(BGP)],the limb motor function[Fugl-Meyer motor assessment(FMA)]score,the activities of daily living[activities of daily living scale(ADL)]score before and after the surgery,and the incidence of complications were compared between the two groups.Results:The excellent and good rate of operation in the observation group was 92.50%(37/40),which was higher than 70.00%(28/40)in the control group,and the difference was statistically significant(P<0.05).The operation time and the postoperative hospitalization time of the observation group were shorter than those of the control group,the intraoperative blood loss and the postoperative drainage volume were less than those of the control group,and the differences were statistically significant(P<0.05).After the surgery,the levels of BALP,PINP and BGP in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After the surgery,the scores of FMA and ADL of the observation group were higher than those of the

关 键 词：创伤性四肢骨折 术后 骨不连 带锁髓内钉内固定术 动力加压钢板内固定术 骨代谢 肢体运动功能 日常生活能力 

分 类 号：R687.3[医药卫生—骨科学]