發(fā)布時(shí)間：2018-03-22 14:30

  本文選題：股骨髓內(nèi)釘　切入點(diǎn)：髓內(nèi)釘尾帽　出處：《中國(guó)修復(fù)重建外科雜志》2017年04期 　論文類(lèi)型：期刊論文

【摘要】：目的研制一種用于封閉股骨交鎖髓內(nèi)釘中心孔尾端的新型尾帽,以減小尾帽植入髓內(nèi)釘?shù)碾y度,保證植入準(zhǔn)確性,減少不必要的手術(shù)時(shí)間。方法 2014年成功研制出一種新型股骨髓內(nèi)釘尾帽(以下簡(jiǎn)稱(chēng)"新型尾帽")并獲國(guó)家實(shí)用新型專(zhuān)利。采用臨床隨機(jī)對(duì)照研究,將2014年8月—2016年3月收治的符合選擇標(biāo)準(zhǔn)的34例非病理性股骨干骨折患者隨機(jī)分為A、B兩組,每組17例。兩組患者性別、年齡、側(cè)別、體質(zhì)量指數(shù)、致傷原因、傷后至手術(shù)時(shí)間、骨折AO分型等一般資料比較差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性。兩組患者均行交鎖髓內(nèi)釘固定術(shù),A、B組分別采用新型尾帽和原配尾帽。術(shù)中測(cè)量并比較兩組植入尾帽的出血量和手術(shù)時(shí)間,術(shù)后比較兩組并發(fā)癥發(fā)生情況和骨折愈合時(shí)間,采用Klemm功能評(píng)定標(biāo)準(zhǔn)評(píng)價(jià)兩組患肢功能。結(jié)果 A組植入尾帽過(guò)程的出血量和手術(shù)時(shí)間分別為(3.5±0.8)m L和(10.57±3.15)s,均顯著少于B組的(5.5±1.7)m L和(21.99±6.90)s,差異有統(tǒng)計(jì)學(xué)意義(t= 8.281,P=0.010;t= 10.743,P=0.009)。A組新型尾帽均一次性植入成功,成功率100%;B組中3例原配尾帽旋入時(shí)脫落,一次性成功率82.4%。兩組患者均獲隨訪(fǎng),隨訪(fǎng)時(shí)間6~16個(gè)月,平均9.7個(gè)月。所有患者均無(wú)深部感染、內(nèi)固定物松動(dòng)或斷裂以及其他嚴(yán)重并發(fā)癥發(fā)生。A、B組達(dá)骨折臨床愈合時(shí)間分別為(16.4±3.2)周和(15.8±3.5)周,差異無(wú)統(tǒng)計(jì)學(xué)意義(t=0.514,P=0.611)。末次隨訪(fǎng)時(shí),根據(jù)Klemm功能評(píng)定標(biāo)準(zhǔn),A組優(yōu)14例、良3例,對(duì)照組優(yōu)11例、良6例,差異無(wú)統(tǒng)計(jì)學(xué)意義(χ~2=0.142,P=0.707)。結(jié)論新型股骨髓內(nèi)釘尾帽使術(shù)中操作簡(jiǎn)便,手術(shù)時(shí)間縮短,出血量減少,治療效果滿(mǎn)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 鹵0.8mm / L and 10.57 鹵3.15m / L, respectively, which were significantly lower than those of group B (5.5 鹵1.7mL and 21.99 鹵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 鹵3.2 weeks in group A and 15.8 鹵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.
【作者單位】： 西南醫(yī)科大學(xué)附屬醫(yī)院骨與關(guān)節(jié)外科;
【基金】：四川省科學(xué)技術(shù)廳科研項(xiàng)目(Z14006)~~
【分類(lèi)號(hào)】：R687

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