新型股骨髓内钉尾帽的研制与临床应用

发布时间：2018-03-22 14:30

本文选题：股骨髓内钉　切入点：髓内钉尾帽　出处：《中国修复重建外科杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的研制一种用于封闭股骨交锁髓内钉中心孔尾端的新型尾帽,以减小尾帽植入髓内钉的难度,保证植入准确性,减少不必要的手术时间。方法 2014年成功研制出一种新型股骨髓内钉尾帽(以下简称"新型尾帽")并获国家实用新型专利。采用临床随机对照研究,将2014年8月—2016年3月收治的符合选择标准的34例非病理性股骨干骨折患者随机分为A、B两组,每组17例。两组患者性别、年龄、侧别、体质量指数、致伤原因、伤后至手术时间、骨折AO分型等一般资料比较差异均无统计学意义(P0.05),具有可比性。两组患者均行交锁髓内钉固定术,A、B组分别采用新型尾帽和原配尾帽。术中测量并比较两组植入尾帽的出血量和手术时间,术后比较两组并发症发生情况和骨折愈合时间,采用Klemm功能评定标准评价两组患肢功能。结果 A组植入尾帽过程的出血量和手术时间分别为(3.5±0.8)m L和(10.57±3.15)s,均显著少于B组的(5.5±1.7)m L和(21.99±6.90)s,差异有统计学意义(t= 8.281,P=0.010;t= 10.743,P=0.009)。A组新型尾帽均一次性植入成功,成功率100%;B组中3例原配尾帽旋入时脱落,一次性成功率82.4%。两组患者均获随访,随访时间6~16个月,平均9.7个月。所有患者均无深部感染、内固定物松动或断裂以及其他严重并发症发生。A、B组达骨折临床愈合时间分别为(16.4±3.2)周和(15.8±3.5)周,差异无统计学意义(t=0.514,P=0.611)。末次随访时,根据Klemm功能评定标准,A组优14例、良3例,对照组优11例、良6例,差异无统计学意义(χ~2=0.142,P=0.707)。结论新型股骨髓内钉尾帽使术中操作简便,手术时间缩短,出血量减少,治疗效果满意。
[Abstract]:Objective to develop a new type of tail cap used to seal the tail end of the central foramen of interlocking intramedullary nail, in order to reduce the difficulty of the tail cap implantation and ensure the accuracy of intramedullary nail implantation. Methods A new type of femoral bone marrow nail tail cap (hereinafter referred to as "new tail cap") was successfully developed in 2014 and obtained a national patent for practical use. From August 2014 to March 2016, 34 patients with non-pathological femoral shaft fractures were randomly divided into two groups: group A (n = 17), gender, age, side, body mass index (BMI), cause of injury, time from injury to operation. There was no significant difference in AO classification and other general data between the two groups. The two groups were treated with interlocking intramedullary nail fixation. The new tail cap and the original tail cap were used in group A and B respectively. Intraoperative measurement and comparison were made between the two groups. The amount of blood lost and the time of the operation, Postoperative complications and fracture healing time were compared between the two groups. Results the bleeding volume and operation time of group A were 3.5 卤0.8mm / L and 10.57 卤3.15m / L, respectively, which were significantly lower than those of group B (5.5 卤1.7mL and 21.99 卤6.90g / s). The difference was statistically significant (t = 8.281). All the tail caps were implanted successfully at one time. The success rate was 100%. In group B, 3 cases fell off when the original tail cap was rotated, and the one-time success rate was 82.4%. All the patients in both groups were followed up for 6 ~ 16 months (mean 9.7 months). No deep infection was found in all the patients. The clinical healing time of fracture was 16.4 卤3.2 weeks in group A and 15.8 卤3.5 weeks in group A. the difference was not statistically significant. At the last follow-up, 14 cases were excellent in group A and 3 cases good in group A according to the criteria of Klemm function evaluation. In the control group, 11 cases were excellent and 6 cases were good, the difference was not statistically significant (蠂 ~ (2) 0.142P ~ (0.707)). Conclusion A new type of femoral bone marrow nail cap can make the operation simple, the operation time shortened, the amount of bleeding reduced, and the therapeutic effect is satisfactory.
【作者单位】：西南医科大学附属医院骨与关节外科;
【基金】：四川省科学技术厅科研项目(Z14006)~~
【分类号】：R687

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