摘要
目的评价胸椎胸骨复合型骨折的不同方式的治疗效果。方法对31例胸椎胸骨复合型骨折病例的治疗进行回顾性分析。31例患者均合并有多处创伤,其中胸椎压缩性骨折15例,骨折脱位11例,爆裂型骨折5例;完全性神经损伤5例,不完全神经损伤16例,无神经损伤10例。手术治疗20例(单纯胸骨手术4例,胸椎手术12例,胸椎胸骨联合手术5例),非手术治疗11人。结果随访时间0.5～5年,平均2.4年。患者均有不同程度的恢复。术后3例完全性神经损伤患者神经功能无明显改善;2例出现迟发型神经功能损害。余27例病情无加重;16例不完全神经损伤患者中3例恢复正常,9例有改善,4例无改善。结论胸骨胸椎复合型骨折多伴有神经损伤及其他多处创伤,病情复杂多变,应根据患者情况制定个体化治疗方案;早期固定胸骨有助于维持脊柱的稳定性,有效预防或延缓脊柱侧弯等疾患的发生进展。
Objective To study the curative effects on the treatment of thoracic vertebral associated with sternal fracture with different therapeutic method. Methods From July 1999 to June 2009, 31 cases with thoracic vertebral associated with sternal fracture received surgical treatment were analyzed retrospectively. Thirty one cases were associated with multiple traumas. Among them, compressive fractures of thoracic vertebrae were in 15 cases, fractures and dislocation in 11 cases and burst fracture in 5 cases. The operative treatment was in 20 cases, including simple sternal operation 4 cases, thoracic vertebral operation 12 cases and thoracic vertebral combined with sternal operation 5 cases. The conservative treatment was in 11 cases. Results Follow-up was got in all cases. Follow-up time ranged from 0.5 to 5-year （average 2.4 years）. These patients had recovery in different degree. The neural function had no improvement significantly in three cases with complete neural injuries. Two cases occurred damage of delayed neural function. The other 27 cases had no aggravation in patient＇s condition. Among the 6 cases with incomplete neural injury patients, 3 cases were recovered to normality, 9 cases had improvement and 4 cases had no improvement. Condusion Because of sternum associated with thoracic vertebral fracture are commonly accompanied by neural injury and multiple injuries and patients condition is complex, an individuated therapeutic project should be established according to patient＇s condition. Early fixation of the sternum would attribute to maintain stability of spinal column and to prevent or delay occurrence and progression of scoliosis.
出处
《岭南现代临床外科》
2010年第4期277-279,共3页
Lingnan Modern Clinics in Surgery
关键词
胸椎
胸骨
复合型骨折
Thoracic vertebrae
Sternum
Compound fractures
