本文選題：股骨骨折 + 微創(chuàng)�。� 參考：《皖南醫(yī)學(xué)院》2016年碩士論文

【摘要】：目的:探討MIPO技術(shù)結(jié)合自體紅骨髓移植股骨遠(yuǎn)端粉碎性骨折治療中的臨床療效。方法:搜集弋磯山醫(yī)院創(chuàng)傷骨科2組2010年至2015年期間收治的OTA分類系統(tǒng)IV~VI型(復(fù)雜性骨折)的股骨粉碎性骨折患者18例,所有患者均為閉合骨折,且經(jīng)初次手術(shù)治療后骨折斷端均存在不同程度的分離。根據(jù)手術(shù)治療方法的不同分為MIPO技術(shù)結(jié)合紅骨髓治療組(A)和單純MIPO技術(shù)治療組(B)。對(duì)A、B兩組手術(shù)時(shí)間、骨折愈合情況、預(yù)后功能評(píng)價(jià)及二次手術(shù)情況進(jìn)行對(duì)比分析。結(jié)果:手術(shù)時(shí)間:A組:最短手術(shù)時(shí)間為60分鐘,最長手術(shù)時(shí)間為120分鐘,平均手術(shù)時(shí)間為77.40±17.10分鐘。B組:最短手術(shù)時(shí)間為50分鐘,最長手術(shù)時(shí)間為105分鐘,平均手術(shù)時(shí)間為88.75±19.93分鐘。A、B兩組手術(shù)時(shí)間無顯著統(tǒng)計(jì)學(xué)差異。骨折愈合情況:術(shù)后3個(gè)月:A組:術(shù)后3個(gè)月復(fù)查X線,有6例患者骨折愈合,愈合率75.0%。B組:術(shù)后3個(gè)月復(fù)查X線,有5例患者骨折愈合,愈合率20.0%。A、B兩組愈合率有顯著統(tǒng)計(jì)學(xué)差異。術(shù)后6個(gè)月:A組:術(shù)后6個(gè)月復(fù)查X線,有7例患者骨折愈合,愈合率87.5%。B組:術(shù)后6個(gè)月復(fù)查X線,有3例患者骨折愈合,愈合率30.0%。A、B兩組愈合率有顯著統(tǒng)計(jì)學(xué)差異。預(yù)后功能評(píng)價(jià):A組:優(yōu)4例,良3例,一般1例,差0例。B組:優(yōu)2例,良4例,一般3例,差1例。A、B兩組優(yōu)良率無顯著統(tǒng)計(jì)學(xué)差異。二次手術(shù):B兩組患者的骨折最終都獲得了愈合,8例患者進(jìn)行了二次手術(shù)植骨,其中A組1例,B組7例。A、B兩組二次手術(shù)率有顯著統(tǒng)計(jì)學(xué)差異。結(jié)論:MIPO技術(shù)結(jié)合自體紅骨髓移植治療股骨遠(yuǎn)端粉碎性骨折時(shí),彌補(bǔ)了MIPO技術(shù)無法糾正骨折斷端分離的不足,并獲得了滿意的療效。MIPO技術(shù)結(jié)合自體紅骨髓移植治療降低了治療費(fèi)用,縮短了治療時(shí)間,減少了病人痛苦,在存在分離移位的股骨遠(yuǎn)端粉碎性骨折的治療中具有明顯優(yōu)勢。
[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 鹵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 鹵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.
【學(xué)位授予單位】：皖南醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R687.3

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