两种方法治疗股骨干骨折合并较大游离骨块的效果比较

发布时间：2018-02-15 02:25

本文关键词： 股骨干骨折游离骨块钻孔植骨　出处：《中国临床解剖学杂志》2017年01期 　论文类型：期刊论文

【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(P0.05)。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±11.31min),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(P0.05)。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。
[Abstract]:Objective to compare the effect of two methods in the treatment of femoral shaft fracture with large free bone mass. Methods 66 cases of femoral shaft fracture with large free bone mass were treated with open reduction and internal fixation. 35 cases were divided into control group, 35 cases in the test group were treated with drilling, transplanting and peripheral bone grafting in cancellous foramen, and reduction and fixation. The operation time, the amount of blood loss and the time of fracture healing were compared between the two groups. Results there was no significant difference in general data between the two groups (P 0.05). The operative bleeding in the control group was 847.58 卤147.53 ml and the operative time was 138.43 卤12.10 min, which was better than that in the experimental group (752.18 卤143.78 ml, respectively). And 115.27 卤11.31 mins, and the fracture healing time was 4.79 卤1.00 months, bone delayed healing was 1.35%, bone nonunion 0) and internal fixation fracture 0) in the experimental group, the incidence and functional recovery were significantly higher than those in the control group (9.49 卤2.59-113358r-435 and 15137r.0%, respectively, P 0.05). For femoral shaft fracture with larger free bone mass, The effect of reduction and fixation was poor, but drilling and cancellous bone grafting could accelerate the speed of crawling instead of healing and improve the mechanical properties of fracture end. The effect of fracture treatment was better than that of the former.
【作者单位】：无锡市第九人民医院骨科;
【分类号】：R687.3

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