摘要
目的探讨对伴有移位骨块的股骨干骨折患者运用交锁髓内钉闭合复位内固定后,移位骨块的大小和移位距离对骨折愈合的影响。方法回顾性分析唐山市第二医院2010年5月-2015年5月应用交锁髓内钉闭合复位内固定治疗的174例股骨干骨折患者,其中男性93例,女性81例;年龄22~65岁,平均40.2岁。根据患者术后移位骨折块的面积大小和移位距离不同分为4组:A组(游离骨折块面积≤15cm2,移位距离≤10mm)60例,B组(游离骨折块面积≤15cm2,移位距离10~20mm)27例,C组(游离骨折块面积:15~30cm2,移位距离≤10mm)62例,D组(游离骨折块面积:15~30cm2,移位距离10~20mm)25例。对4组患者的平均骨折愈合时间、骨折一期愈合率和总愈合率及术后临床疗效进行对比分析。结果4组患者各项指标比较均有统计学意义,其中A组患者骨折愈合情况最好,骨折愈合率为98.33%,D组愈合情况最差,骨折愈合率为56%,B、C组介于A组和D组之间且C组患者愈合情况优于B组。A、B、C、D组临床疗效优良率分别为96.67%、77.78%、83.87%、48.00%。结论移位骨块的面积或移位距离增大均会对骨折愈合产生不利的影响,当骨块移位距离>10mm、面积>15cm2时骨折愈合率及术后临床疗效明显降低,因此临床上治疗此类患者时应当给予足够重视,必要时给予临床干预,以防术后骨折延迟愈合或不愈合情况的发生。
Objective To investigate the effect of displaced bone blocks on fracture healing in patients with femoral shaft fracture treated with interlocking intramedullary nail. Methods A total of 174 patients [ 93 males and 81 females, aged 40.2（22 -65） years] with femoral shaft fractures treated by interlocking intramedullary nail from May 2010 to May 2015 were retrospectively analyzed. According to the size and distance of the displaced bone, they were divided into 4 groups ： group A （ the area of displaced bone blocks is less than or equal to fifteen square centimeters, the shift distance of bone blocks is less than or equal to ten millimeter, n = 60 ） , group B （ the area of free fracture block is less than or equal to fifteen square centimeters, the shift distance of bone blocks is greater than ten and less than twenty millimeter, n = 27 ） , group C （ the area of free fracture block is greater than fifteen and less than thirty square centimeters, the shift distance of bone blocks is less than or equal to ten millimeter, n = 62 } and group D （ the area of free fracture block is greater than fifteen and less than thirty square centimeters, the shift dis- tance of bone blocks is greater than ten and less than twenty millimeter, n = 25 }. Then the fracture healing time, the fracture healing rate and the postoperative clinical curative effect of the four groups were compared. Results Com- parison between the four groups indicated that, the indicators were all statistically significant. Group A had the best healing condition （98.33% ） while group D had the worst condition （56% ）. The excellent and good rate of group A, B, C, D was 96.67%, 77.78%, 83.87% and 48.00% , respectively. Conclusion The free bone block has influence on fracture healing. When the area of the displaced bone blocks and the shift distance of bone increases, the corresponding bone defect area is also increased, so the fracture healing time is prolonged, the fracture healing rate and the excellent rate of postoperative function
作者
王雪兵
李力更
吴志新
王志生
WANG Xue-bing LI Li-geng WU Zhi-xin WANG Zhi-sheng(Department of Trauma, Second Hospital of Tangshan, Hebei 063000, Chin)
出处
《创伤外科杂志》
2017年第8期574-577,共4页
Journal of Traumatic Surgery
关键词
股骨干骨折
髓内钉
移位骨块
愈合
内固定
femoral shaft fracture
intramedullary nail
displaced bone blocks
healing
internal fixation
