恢复骨皮质完整性对促进股骨胫骨粉碎性骨折愈合疗效分析.docVIP

恢复骨皮质完整性对促进股骨胫骨粉碎性骨折愈合疗效分析 　　[摘要] 目的 探讨在治疗粉碎性股骨、胫骨骨折时开放恢复骨皮质完整性和微创LISS钢板内固定的疗效。 方法 选择2012年12月～2014 年12月我院手术治疗的股骨髁上粉碎性骨折、胫骨近端粉碎性骨折75例，随机分为两组，观察组39例，行切开复位尽可能恢复骨皮质完整性。对照组36例，行经皮微创钢板内固定。对比分析两组术后的骨折愈合时间及Merchan评分。采用Merchan评分评价治疗效果。 结果 手术顺利完成，均经 6～24 个月随访，观察组骨折愈合时间（16.2±3.4）周，对照组（16.2±3.0）周，两组骨折愈合时间比较差异无统计学意义（P0.05）；Merchan方法评分，观察组总优良率为 87.18%，对照组总优良率为 75.00%，两组差异有统计学意义（P0.05）。 结论 在治疗粉碎性骨折时恢复骨皮质完整性促进骨折愈合效果明显，但在操作上要遵循微创原则，减少剥离，保护血供。 　　[关键词] 恢复骨皮质完整性；粉碎性骨折；骨不愈合；骨折延迟愈合 　　[中图分类号] R683.4 [文献标识码] B [文章编号] 1673-9701（2016）12-0052-03 　　Explore the curative effect of recovering the integrity of bone cortex on comminuted fracture of femur and tibia 　　YAN Maohua ZHU Qiuliang XU Guorong ZHANG Xuechao 　　Department of Orthopedics， the Peoples Hospital of Anji County in Zhejiang Province， Anji 313300， China 　　[Abstract] Objective To explore the clinical efficacy for the treatment of comminuted femur and tibia fracture between the open recovering the integrity of bone cortex and the minimally invasive plate with less invasive stabilization system （LISS）. Methods From December 2012 to December 2014， A total of 75 patients suffering from comminuted fracture on femoral and proximal tibia were divided into two groups：39 cases in open recovering the integrity of bone cortex and 36 cases in mini incision approach， The postoperative Merchan score and the healing time of bone was recorded. The curative effect was compared according to Merchan score system. Results All cases were finished successfully ，with the followed up 6-24 months， the healing times of bone was（16.2±3.4） weeks and（16.2±3.0） weeks， without significant difference（P0.05）. The postoperative Merchan Score was 87.18% and 75.00%， and there was significant difference between the two groups（P0.05）. Conclusion In terms of comminuted fracture treatment， recovering the integrity of bone cortex has a significant curative effect of promoting fracture healing，but the minimally-incisive principle reducing strip and protecting blood su