万向锁定接骨板内固定治疗大关节周围粉碎性骨折的临床疗效观察

发布时间：2018-01-20 03:46

本文关键词： 万向锁定接骨板大关节周围粉碎性骨折内固定术　出处：《中国矫形外科杂志》2017年18期 　论文类型：期刊论文

【摘要】：[目的]探讨经皮微创万向锁定接骨板治疗大关节周围粉碎性骨折的临床疗效。[方法]回顾性分析2012年10月~2015年6月诊治的大关节周围粉碎性骨折78例,随机将78例患者分为万向锁定接骨板组36例(万向组)和普通锁定接骨板组42例(单向组)。比较两组的手术时间、术中出血量、骨折愈合时间、术后并发症及术后Johner-Wruhs功能评分。[结果]两组手术时间和术中失血量相比差异无统计学意义(P0.05)。78例患者均得到12~24个月随访,平均16.4个月。两组患者各有2例切口出现浅表感染,经定期换药后好转。末次随访时万向组的Johner-Wruhs功能评分高于单向组,差异有统计学意义(P0.05)。万向组的骨折愈合时间、内固定失败和术后并发症少于单向组,差异有统计学意义(P0.05)。[结论]万向锁定接骨板与普通锁定接骨板内固定均能有效对大关节周围粉碎性骨折进行治疗,具有创伤小、操作简单、愈合率高、关节功能恢复好等优点,但万向锁定接骨板具有操作更简便、骨折愈合较快及术后并发症更少等优点。
[Abstract]:[Objective] to investigate the clinical effect of percutaneous minimally invasive universal locking plate in the treatment of comminuted fractures around major joints. [Methods: a retrospective analysis of 78 cases of comminuted fractures around major joints from October 2012 to June 2015 was performed. Seventy-eight patients were randomly divided into universal locking plate group (gimbal group, 36 cases) and common locking plate group (42 cases, unilateral group). The operation time, intraoperative bleeding volume and fracture healing time were compared between the two groups. Postoperative complications and postoperative Johner-Wruhs score. [Results: there was no significant difference in operation time and blood loss between the two groups (P 0.05). 78 patients were followed up for 12 ~ 24 months. The average of 16.4 months was 16.4 months. There were 2 cases of superficial infection of incision in each group, which were improved after regular dressing change. At the last follow-up, the score of Johner-Wruhs function in the universal group was higher than that in the unidirectional group. The fracture healing time, the failure of internal fixation and postoperative complications in the gimbal group were less than those in the one-way group, and the difference was statistically significant (P 0.05). [Conclusion: both universal locking plate and common locking plate can effectively treat comminuted fracture around large joint, which has the advantages of small trauma, simple operation, high healing rate and good recovery of joint function. But the universal locking plate has the advantages of simple operation, quick fracture healing and less postoperative complications.
【作者单位】：贵州盘江投资控股(集团)有限公司总医院骨一科;
【分类号】：R687.3
【正文快照】： 四肢长骨关节周围粉碎性骨折大多累及关节面,一直是临床治疗的难题,钢板内固定是临床较常用的治疗方法,但术后钢板断裂、骨折不愈合及关节功能障碍等并发症较多。现回顾性分析本院2012年10月~2015年6月应用万向锁定接骨板及普通锁定钢板治疗78例大关节周围粉碎性骨折,比较两种

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