两种方法治疗股骨干骨折合并较大游离骨块的效果比较

doi:10.13418/j.issn.1001-165x.2017.01.020

摘要/Abstract

摘要：

目的　比较两种方法治疗股骨干骨折合并较大游离骨块的效果差异。方法　选择66例股骨干骨折合并较大游离骨块行切开复位内固定治疗患者。按游离骨块处理方法不同分为对照组（35例，仅复位固定，未行钻孔和植骨）和试验组（35例,行钻孔、松质骨孔内插秧式植骨和周围植骨，以及复位固定）。比较两组的手术时间、手术出血量、骨折愈合时间、并发症发生情况和末次随访时临近关节功能恢复（HSS法）。结果　两组患者一般资料比较差异无统计学意义（P>0.05）。对照组的手术出血(847.58±147.53) ml和手术时间(138.43±12.10) min优于试验组（分别752.18±143.78 ml和115.27±11.31 min），而试验组的骨折愈合时间（4.79±1.00 月）、骨延迟愈合（1/35）、骨不连（0）和内固定断裂（0）的发生率以及功能恢复（26/5/0/0）均优于对照组（分别为9.49±2.59 月，11/35，8/35，4/35和15/13/7/0），差异均有统计学意义（P<0.05）。结论　对于股骨干骨折合并较大游离骨块，仅复位固定的效果较差，而采用钻孔、松质骨植骨可以加快爬行替代愈合速度和改善骨折端的力学性能，骨折治疗效果明显优于前者。

关键词: 股骨干骨折, 游离骨块, 钻孔, 植骨

Abstract:

Objective　To compare the difference in effect of two methods g for treatment of large free bone block associated with femoral shaft fractures. Methods 66 cases of femoral shaft fractures with large free bone block treated by open reduction and internal fixation were selected.According to different methods for large free bone block,they were divided into control group(35 cases,treated without drilling and without bone grafting) and test group(35 cases,treated with drilling and cancellous bone grafting liking rice transplant in the holes and surrounding).The two groups were compared in terms of operation time,operative bleeding,healing time of fracture,morbidity of complications and functionary recovery of the adjacent joints(HSS’s criterion) at the last follow-up. Results The two groups were not significantly different in clinical data (P>0.05).The operation bleeding (847.58±147.53 ml) and operative time (138.43±12.10 min) in the control group were superior to those in the test group（752.18±143.78 ml and 115.27±11.31 min, respectively）, but the healing time of fracture（4.79±1.00 month）, the morbidity of delayed healing(1/35), nonunion (0) and broken of internal fixation (0)，as well as the functionary recovery in the test group were superior to those in the control group (9.49±2.59 month，11/35，8/35，4/35 and 15/13/7/0, respectively), the differences were statistically significant (P<0.05).　Conclusion　As for free bone block associated with femoral shaft fractures, simple reduction and fixation has unsatisfied result,but drilling and cancellous bone grafting can promote healing of creeping substitution and improve mechanical property in the fracture ends, the result is superior to that in the former.

Key words: Femoral shaft fracture, Free bone block, Drilling, Bone graft

殷渠东，　顾三军，　徐可林，　芮永军，　孙振中，　刘军. 两种方法治疗股骨干骨折合并较大游离骨块的效果比较[J]. 中国临床解剖学杂志, 2017, 35(1): 98-101.

YIN Qu-dong, GU San-jun, XU Ke-lin, RUI Yong-jun, SUN Zhen-zhong, LIU Jun. Effect comparison of two methods for treatment of large free bone block associated with femoral shaft fractures[J]. Chinese Journal Of Clinical Anatomy, 2017, 35(1): 98-101.

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