骨皮质剥脱术联合锁定接骨板内固定术治疗四肢长骨骨不连的疗效
张建军1 ，黄鲁豫2 ，冯晓飞2，张小栋2 ，张宝强2
（1.陕西省汉中市职业技术学院附属医院，陕西 汉中，723000；2.第四军医大学西京医院，陕西 西安，710032）
浏览次数：71次 下载次数：314次
摘要：
目的 探讨四肢长骨骨不连患者在骨皮质剥脱术的基础上联合锁定接骨板内固定术的疗效。方法 选取我院收治的82 例四肢长骨骨不连患者，随机分为对照组（给予骨皮质剥脱术治疗，n=41）与观察组（在骨皮质剥脱术治疗的基础上联合锁定接骨板内固定术治疗，n=41），观察两组治疗效果及骨折愈合时间、日常生活能力评分及并发症发生情况。结果 观察组患者的治疗优良率明显高于对照组（X2=8.194，P<0.05）。术后，两组患者的日常生活能力评分均明显高于术前，且术后观察组患者的日常生活能力评分显著高于对照组，骨折愈合时间短于对照组（P<0.05）。两组患者均未出现畸形愈合，观察组患者术后并发症总发生率低于对照组（P<0.05）。结论 四肢骨骨不连在骨皮质剥脱术基础上进行锁定接骨板内固定治疗，效果显著，促进骨折愈合，且术后并发症少，具有推广价值。
关键词：四肢长骨骨不连；锁定接骨板内固定术；骨皮质剥脱术
中图分类号：R687.3 文献标志码：A文章编号：2096-1413(2017)22-0043-02
Clinical effect of cortical bone decortication combined with internal locking fixation in patients with
long bone nonunion of limbs
ZHANG Jian-jun 1, HUANG Lu-yu 2, FENG Xiao-fei 2, ZHANG Xiao-dong 2, ZHANG Bao-qiang 2
(1. the Affiliated Hospital of Hanzhong City Vocational and Technical College, Hanzhong 723000; 2. Xijing Hospital of the Fourth Military
Medical University, Xi``an 710032, China)
ABSTRACT: Objective To study the clinical effect of cortical bone decortication combined with internal locking fixation in patients with long bone nonunion of limbs. Methods Eighty-two patients with long bone nonunion of limbs in our hospital were selected and randomly divided into control group (accepted the bone decortication, n =41) and observation group (accepted cortical bone decortication combined internal locking fixation, n =41). The clinical effect, fracture healing time, daily life ability score and complications of the two groups were observed. Results The excellent rate of treatment in the observation group was significantly higher than that in the control group ( X2=8.194, P<0.05). After operation, the scores of daily life ability of the two groups were significantly higher than those before operation, the score of daily life ability in the observation group was significantly higher than the control group, and the fracture healing time was shorter than that of the control group (P <0.05). There were no healed deformities in both groups, and the overall incidence of postoperative complications in the observation group was lower than that in the control group (P<0.05). Conclusion The combined therapy of bone decortication and internal fixation of locking plate has obvious effect in the treatment of long bone nonunion of limbs, which can shorten the healing time of bone fracture and reduce the incidence rate of complications. It is worthy of promotion.
KEYWORDS: long bone nonunion of limbs; internal fixation of locking plate; bone decortication
参考文献：
[1] 刘洪智,刘洁,王新,等.自体骨髓干细胞联合不同支架材料移植治疗四肢长骨骨不连[J].中华实验外科杂志,2012,29(6):1200.
[2] 张延琴,牛志霞,李荣,等.重组合异种骨植入治疗四肢长骨骨不连的护理[J].中华现代护理杂志,2011,17(30):3647-3649.
[3] 殷渠东,顾三军,孙振中,等.植骨在预防四肢骨折术后骨不连的价值[J].中国骨与关节损伤杂志,2013,28(5):431-433.
[4] 王元山,陈建明,陈雪松,等.负载万古霉素人工骨与外固定架治疗感染性长骨不连[J].西南国防医药,2012,22(11):1206-1207.
[5] 尚大财,刘钦林,钟生财,等.Ilizarov 骨滑移技术治疗四肢长骨创伤性骨髓炎的临床研究[J].中国矫形外科杂志,2016,24(3):220-225.