浅析应用可吸收内固定材料治疗舟骨骨折.docVIP

浅析应用可吸收内固定材料治疗舟骨骨折 　　　【论文关键词】 舟骨骨折；可吸收钉 　　【论文摘要】 目的总结可吸收钉治疗舟骨骨折的经验和教训。方法 2006年6月至2007年12月,应用自身增强-聚乙酯(self-reinforced polyglycolicacid,SR-PGA)、自身增强-聚丙酯(self-reinforced poly-L-Lacticacid,SR-PLLA)可吸收螺钉手术处理舟骨骨折13例,其中男8例,女5例。年龄21~62岁。手术时间为伤后14~85 d。应用SR-PGA全螺纹钉13枚,术后用腕中位及桡侧屈位石膏外固定。结果 患者术后获随访6~20个月,平均18个月,伤口均 1期愈合;骨折于1~3个月内达临床愈合,无再移位、感染及局部积液。患者关节功能恢复满意。根据美国骨科协会(AASO)关节功能评价:优9例,良3例,可1例,优良率92.3%。结论 可吸收内固定钉治疗关节内及关节周围骨折,免除了患者二次手术取出内固定物的痛苦,是一种有效和较为理想的方法。 　　 　　 　　【Abstract】 Objective To summarise the experiences in thetherapy for fracture ofthe scaphoid with absorbable screws.Methods From 2006 to 2007,13 patients with fracture were treated by absorbable screws and of 13 patients, 8were males and 5 were females of aged from 21~62 years.All cases interval between injury and operation was 14~89 days. Fracture were fixed with fullthread screws of SR-PGA in 13 cases, Bone tractionor plasterexternal fixation were carried out postoperatively. Results The patients were followed from 6~20 months with an average of 18 months. The wounds healed by first intention, and the healing time of bone was 1-3 months. No dislocation, infection and local effusion occurred. Functional recovery was satisfactory. According to AASO articular function standard, the results were, excellent in 9 cases, good in 3cases , and fair in 1 case; the total excellent and good rate was 92.3%. Conclusion Internal fixation of absorbable screws in the therapy for fracture of the scaphoid was effective measure which can avoid the pain of taking out internal fixation of second operation. 　　【Key words】 Fracture ofthe scaphoid；Absorbable screw 　　 　　 　　从芬兰的Rokkanen教授首先报道应用可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20余年时间,这种材可吸收内固定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,目前在项内固定技术已十分成熟。本科自2006年6月至2007年12月利用此项技术对13例患舟骨骨折者进行内固定治疗,取得良好疗效。现报告如下。 　　 　　1 资料与方法 　　 　　1.1 一般资料 共有13例，男8例,女5例。年龄21~62岁。病史时间14~85 d。其中复合伤11例，均为舟骨腰部骨折，经X线诊断，保守治疗无效或加重。 　　1.2 手术方法 手术切口自第一掌骨基底部，经“解剖学鼻咽窝”向近端至其近商2~3 cm做一S形切口。切开皮肤及皮下组织，可见桡神经浅支及头静脉，分别予以分离和保护，于拇长伸肌腱和拇短伸肌