可吸收固定材料治疗关节内骨折临床应用.doc

可吸收固定材料治疗关节内骨折临床应用【摘要】目的：评价可吸收材料治疗关节内骨折的临床效果。方法：32例关节内骨折患者应用可吸收螺钉及固定棒[自身增强聚乙酯（self-reinforced polyglycolic acid，SR-PGA），自身增强聚丙酯（self reinforced poly-L-Lactic acid，SR-PLLA）]将骨折复位后固定，术后常规应用抗生素预防感染，行骨牵引或石膏外固定。结果：患者伤口均Ⅰ期愈合，关节内骨折1~3个月内均达到临床愈合，关节功能基本正常，无再移位、感染及局部积液。术后随访5~48个月，平均25个月，关节功能评价（AASO）：优22例，良7例，可2例，差1例，优良率90.6%。结论：可吸收内固定材料是关节内骨折理想的内固定材料，能被完全吸收骨化。 【关键词】关节内骨折；可吸收螺钉；内固定 文章编号：1009-5519（2007）20-3018-03 中图分类号：R6 文献标识码：A Clinical analysis of intra-articular fracture treated with absorbable screws and rods LUOBing，KANG Xiao-ping，YANG Bo （Department of Orthopedics，The People Hospital of Suining， Sichuan 629000,China） 【Abstract】Objective：To assess the curative effect of intra-articular fracture treated with absorbable screws androds. Methods：32 patients with intra-articular fracture were treated by absorbablescrews and rods made of self-reinforced polyglycolic acid（SR-PGA） and self-reinforced poly-L-Lacticacid（SR-PLLA）.After operation，the antibiotics were used to prevent infection. Skeletal traction and plaster external fixation were used too. Results：The wounds healed by first intention and the healing time of bone was 1~3 months.No dislocation，infection and local effusion occurred. The patients were followed up from 5 months to 48 months with an average of 25 months.Functional recovery was satisfactory.According to AASO articular function standard，the results were excellent in 22cases，good in 7 cases，fair in 2 case，and poor in 1 case. The total excellent and good rate was 90.6%. Conclusion：Internal fixation of absorbable screws and rods， which can be absorbed and ossified completely，is a perfect procedure in treating intra-articular fracture. 【Key words】Intra-articular fracture；Absorbable screw and rod；Internal fixation 尽管金属内固定治疗骨折已成为较成熟的技术，但其存在局部腐蚀、应力遮挡以及需再次手术取出的弊端[1]。自可吸收聚合材料1984年由Tomala和Rokkanen博士应用于踝部骨折内固定并取得良好的效果后，作为一种新型内固定材料逐渐应用于临床，特别是应用于关节内骨折的治疗[2]。采用可吸收内固定物治疗关节内骨折具有显著优越性，这种产品勿需二次手术取出，对关节周围组织及关节本身损伤小，组织相容性好，并发症少，可免除患者再次手术的心理压力。2003年5月~2005