可吸收螺钉治疗关节部位骨折.DOCVIP

临床医学论文-可吸收螺钉治疗关节部位骨折 【摘要】? 目的 总结可吸收螺钉治疗关节部骨折的经验与教训。方法 对47例关节部位骨折根据骨块体积及受力大小选择相应粗细、长度和数量的螺钉。手术垂直骨折线钻孔、测深、丝攻，尾部用埋头器处理后拧入螺钉。结果 优26例、良19例、差2例。优良率为957%。结论 可吸收螺钉无毒、组织相容性好，可完全降解吸收，且吸收时间符合骨折愈合规律，不仅可使病人免受二次手术痛苦，而且还能减少手术感染及创伤机会。 【关键词】? 骨折；关节部位；可吸收螺钉 　　Bone Fracture at Joint Treated with Absorbable Screws 　　Zhang Zhuoming, Zhang Xiaofeng, Yu Zuan? 　　(Department of Orthopaedics, Zhejiang Corps Hangzhou Hospital of Chinse Peoples Armed Police Forces, Hangzhou 310051, China) 　　Abstract： Objective? To summarize the experiences in the therapy for bone fracture at joint treated with absorbable screws.Methods?Absorbable screws, whose diameter, length and number were selected according to the fracture mass volume and the pressure on it, were applied to 47 patients with bone fracture at joint. The operation consisted of drilling holes vertical to the fracture line, detecting depth, fastening screws, and so on.Results?The therapeutic outcome resulted in excellent cure in 26, good cure in 19, and bad cure in two patients. The excellent and good healing rate got to 95.7%.Conclusion?Absorbable screw is innoxious, compatible with human tissue and completely degradable. Its absorbing time accords with the healing regularity of bone fracture. The application of absorbable screw can not only prevent the fracture patients from suffering from repeated operation, but decrease the opportunity of infection and further trauma. 　　Key? words：? fracture; joint; absorbable screw ??? 自1984年芬兰的Rokkanen教授首先报道把吸收内固定技术以来，可吸收内固定物在骨科领域使用已有10余年时间，这种材料不同于金属内固定物，可在体内完全降解为水和二氧化碳[1]，免受二次手术之苦，目前在此项内固定技术已十分成熟。我科自2002年1月—2004年12月利用此项技术对47例关节部位骨骨松质折的患者进行内固定治疗，取得良好疗效。现报告如下。 　　1? 资料与方法 　　1．1? 一般资料? 　　本组47例中，男性35例，女性12例，男女之比为2．9：1。年龄19~65岁，平均41．3岁。其中内踝骨折31例，肱骨大结节撕脱性骨折4例，肱骨内或外侧髁撕脱性骨折4例，桡骨小头骨折1例，股骨头骨折3例，股骨内或外侧髁撕脱性骨折2例，胫骨髓间隆突骨折1例，胫骨前缘撕脱性骨折1例。 　　1．2? 内固定材料和器械 ?　　可吸收螺钉有自身增强聚乙交酯（SRPGA）和自身增强聚丙交酯（SRPLLA）两种，常规分全螺纹钉及半螺纹拉力钉，本组中选用国产“Dixfix”或芬兰进口“Biodix”产品。内固定器械为钻头、测深、攻丝、埋头器及特制的螺丝刀。　　　　1．3? 手术方法? 　　手术切口与金属内固定相同，手术显露骨折部位，清