MIPO技术结合红骨髓治疗股骨远端粉碎性骨折的疗效分析

发布时间：2018-06-05 18:38

本文选题：股骨骨折 + 微创　；参考：《皖南医学院》2016年硕士论文

【摘要】：目的:探讨MIPO技术结合自体红骨髓移植股骨远端粉碎性骨折治疗中的临床疗效。方法:搜集弋矶山医院创伤骨科2组2010年至2015年期间收治的OTA分类系统IV~VI型(复杂性骨折)的股骨粉碎性骨折患者18例,所有患者均为闭合骨折,且经初次手术治疗后骨折断端均存在不同程度的分离。根据手术治疗方法的不同分为MIPO技术结合红骨髓治疗组(A)和单纯MIPO技术治疗组(B)。对A、B两组手术时间、骨折愈合情况、预后功能评价及二次手术情况进行对比分析。结果:手术时间:A组:最短手术时间为60分钟,最长手术时间为120分钟,平均手术时间为77.40±17.10分钟。B组:最短手术时间为50分钟,最长手术时间为105分钟,平均手术时间为88.75±19.93分钟。A、B两组手术时间无显著统计学差异。骨折愈合情况:术后3个月:A组:术后3个月复查X线,有6例患者骨折愈合,愈合率75.0%。B组:术后3个月复查X线,有5例患者骨折愈合,愈合率20.0%。A、B两组愈合率有显著统计学差异。术后6个月:A组:术后6个月复查X线,有7例患者骨折愈合,愈合率87.5%。B组:术后6个月复查X线,有3例患者骨折愈合,愈合率30.0%。A、B两组愈合率有显著统计学差异。预后功能评价:A组:优4例,良3例,一般1例,差0例。B组:优2例,良4例,一般3例,差1例。A、B两组优良率无显著统计学差异。二次手术:B两组患者的骨折最终都获得了愈合,8例患者进行了二次手术植骨,其中A组1例,B组7例。A、B两组二次手术率有显著统计学差异。结论:MIPO技术结合自体红骨髓移植治疗股骨远端粉碎性骨折时,弥补了MIPO技术无法纠正骨折断端分离的不足,并获得了满意的疗效。MIPO技术结合自体红骨髓移植治疗降低了治疗费用,缩短了治疗时间,减少了病人痛苦,在存在分离移位的股骨远端粉碎性骨折的治疗中具有明显优势。
[Abstract]:Objective: to investigate the clinical effect of MIPO combined with autologous red bone marrow transplantation in the treatment of comminuted distal femur fracture. Methods: eighteen cases of femoral comminuted fractures treated with OTA classification system IV~VI type (complex fracture) were collected from 2010 to 2015 in trauma orthopedics department of Yogishan Hospital, all of them were closed fractures. After the first operation, the fracture ends were separated to different degrees. According to the different surgical treatment methods, the patients were divided into two groups: MIPO combined with red bone marrow therapy group and simple MIPO treatment group. The operative time, fracture healing, prognostic function and secondary operation were compared and analyzed in group A and B. Results: in group A, the shortest operation time was 60 minutes, the longest operation time was 120 minutes, the average operation time was 77.40 卤17.10 minutes. In group B, the shortest operative time was 50 minutes, and the longest operation time was 105 minutes. The mean operative time was 88.75 卤19.93 minutes. There was no significant difference between the two groups. Fracture healing: group A: 3 months after operation: X-ray examination 3 months after operation, 6 cases of fracture healing, healing rate 75.0. B: 3 months after surgery, 5 cases of fracture healing, 5 cases of fracture healing, 3 months after operation, 3 months after operation, 5 cases of fracture healing. There was significant difference in healing rate between two groups. 6 months after operation, in group A, X-ray examination was performed 6 months after operation. There were 7 cases of fracture healing, and the healing rate was 87.5%. Group B: 6 months after operation, 3 cases had fracture healing. The healing rate of group 30.0.AnB was significantly different between the two groups. Prognostic function evaluation group: excellent 4 cases, good 3 cases, average 1 case, poor 0 cases. B group: excellent 2 cases, good 4 cases, average 3 cases, poor 1 case. Bone graft was performed in 8 patients with secondary operation. The rate of secondary operation in group A (1 case) and group B (7 cases) was significantly different from that in group A (7 cases). The rate of secondary operation in group A was significantly higher than that in group B (n = 7), and there was significant difference in the rate of secondary operation between group A and group B (n = 7). Conclusion in the treatment of comminuted fracture of distal femur with the combination of bone marrow transplantation with autologous red bone marrow transplantation, the MIPO technique can not correct the broken end separation of the fracture. A satisfactory curative effect. MIPO combined with autologous red bone marrow transplantation can reduce the treatment cost, shorten the treatment time and reduce the pain of the patients. It has obvious advantages in the treatment of comminuted fracture of distal femur with separation and displacement.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R687.3

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