桥接系统混棒结构点式接触固定治疗肱骨干骨折
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苏州大学附属常州市肿瘤医院

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R683.41

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Bridge combined internal fixation system with mixed-rod in the treatment of humeral shaft fracture by point contact fixation
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苏州大学附属常州市肿瘤医院

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    摘要:

    摘要:[目的] 探讨桥接系统混棒结构点式接触固定治疗肱骨干骨折的疗效。[方法]回顾性分析2016年1月至2018年12月我院应用桥接系统行手术治疗的肱骨干骨折患者37例,其中混棒结构点接触固定18例,双棒结构固定19例。比较两组围手术期、随访及影像资料。[结果] 两组患者均顺利完成手术,PC-Fix组手术时间、术中出血量及切口长度低于BCFS组,术中透视次数多,差异具有统计学意义(P<0.05)。两组患者住院时间差异无统计学意义(p>0.05)。术后两组肩外展-内收、肘屈-伸活动度及ASES评分随时间均显著增加(P<0.05)。在术后1月时,PC-Fix组的肩外展-内收、肘屈-伸活动度及ASES评分优于BCFS组(P<0.05)。在术后6月及末次随访时,两组的肩肘关节活动度及ASES评分差异无统计学意义(p>0.05)。术后Matta放射学标准评估,PC-Fix组和BCFS组骨折复位优良率分别为78%、89%,差异无统计学意义(p>0.05)。PC-Fix组骨折愈合时间优于BCFS组(P<0.05)。两组均未见内固定物松动、断裂。[结论] 桥接系统构建混棒结构点式接触治疗肱骨干骨折创伤小、组织血供破坏少,有利于骨折愈合,可作为一种新的肱骨干骨折治疗方案。

    Abstract:

    Abstract:[Objective] To evaluate the efficacy of bridge combined internal fixation system with mixed-rod by point contact fixation for femoral shaft fractures. [Methods] A retrospective study was conducted on 37 patients with humerus shaft fracture who treated by bridging system in our hospital from January 2016 to December 2018.Of them, 18 cases received point-contact fixation with mixed rod, while the other 19 cases had double-rod. The data were compared between the two groups regarding to perioperative, follow-up and radiographic aspects. [Results] All the patients in both groups had operations completed smoothly . The PC-Fix group had significantly shorter operation time, less blood loss and incision length, whereas more X-ray exposure than the BCFS group (P<0.05),regardless of no significant difference in hospital stay between the two groups (p>0.05).The shoulder abduction – adduction and elbow flexion - extension range of motion, ASES score in both groups increased significantly with time (P<0.05). The scores of shoulder abduction – adduction and elbow flexion - extension activity, ASES in the PC-Fix group were superior to those in the BCFS group (P<0.05) at one month after surgery. However no significant differences regarding the range of motion and ASES scores between the two groups were proved at 6 months after surgery and the last follow-up (p>0.05).According to the Matta radiological criteria, the excellent and good rates was 78% in PC-Fix group and 89% in the BCFS group. There was no significant difference between them(p>0.05).The fracture healing time of PC-Fix group was better than BCFS group (P<0.05).The loosening or breaking of fixator wasn’t observed in both groups. [Conclusion ] BCFS with mixed-rod combined with point contact fixation for the treatment of humeral shaft fractures can be less traumatic and tissue blood supply damaged, which is conducive to early healing of fractures and may be used as a new treatment for humeral shaft fractures.

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  • 收稿日期:2020-11-20
  • 最后修改日期:2021-01-07
  • 录用日期:2021-02-08
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