有限剥离骨膜对老年人股骨干骨折愈合的影响.pdfVIP

中国骨伤2007年12月第2O卷第12期 China J O~hop＆Trauma，Dec．2007，v01．20．No．12 · 经 验 交 流 · 有限剥离骨膜对老年人股骨干骨折愈合的影响 丁小丰’，詹振宇’，周根欣’，唐海军’，刘耀升 (1．诸暨市第六人民医院骨科，浙江 诸暨 311801；2．浙江大学医学院附属第二医院骨科) 【摘要】 目的：探讨有限剥离骨膜对老年人股骨干骨折的疗效和安全性。方法：应用钢板固定治疗老年人股 骨干骨折45例，男32例，女l3例；年龄58～8l岁，平均(69．5．4-7、1)岁。分别采用常规骨膜剥离方法或有限(微创 术式)骨膜剥离后，行复位和钢板固定。其中有限骨膜剥离(A组)27例，按Anderson分型：I型l5例，Ⅱ型8例， Ⅲ型4例。常规骨膜剥离l8例(B组)，I型8例，Ⅱ型5例，Ⅲ型5例。分别对两组骨痂形成状况、骨折愈合时间 及并发症进行比较。结果：术后随访l0～24个月，平均l8个月，有限骨膜剥离方法骨痂形成状况、骨折愈合时间与 常规骨膜剥离方法相比差异有统计学意义(P0．05)，A组优于B组；骨折延迟愈合、非感染性骨不连及骨折畸形 愈合等并发症的发生差异亦有统计学意义(P0．01)，B组并发症发生率高于A组。结论：有限骨膜剥离钢板固定 治疗老年人股骨干骨折是一种安全、有效的方法。与常规骨膜剥离方法相比，有限骨膜剥离具有骨折愈合时间短、 并发症少等优点。 【关键词】 股骨骨折； 骨折愈合； 骨膜；骨折固定术，内； 老年人 Effects of limited i~riosteal stripping on the union of femoral shaft fractures in the aged DING Xiao-feng’，ZHAN Zhen—yu，ZHOU Gen—xin，TANG Hai-jun， Yao—sheng．’Department ofOrthopaedics，the Sixth People s Hospital ofZhuji， Zhuji 311801，Zhejmng，China ABSTRACT Objective：To explore the therapeutic effects and safety of limited periosteal stripping on the union of femoral shaft fractures in the old people．Methods：A retrospective study was unde~aken in 45 old patients with femoral shaft fractures． Among the patients，32 patients were male and 13 patients were female，aged from 58 to 81 years with a mean age of69．5．4-7．1 years、The patients were treated with traditional periosteal stripping or limited(micro trauma)perlosteal stripping followed by reduction and internal fixation with a plate．Twenty—seven patients were treated with limited periosteal stripping，including (according to Anderson classification)Type I(n=15)，TypeⅡ(n=8)，TypeⅢ(n=4)、Eighteen patients were treated with traditional periosteal stripping，including Type I(n=8)，1ypeⅡ(n=5)，Typelll(n=5)．The porosis，healing time offracture and complications were compared between the two groups．Results：All patients were followed—up postopera