CAJ | 학술논문

背景：髓内钉、钢板和外固定支架在股骨干粉碎性骨折的治疗上各有优势和局限性。目的：探讨桥接组合式内固定系统治疗股骨干粉碎性骨折的效果以及生物力学特点。 　　方法：应用桥接组合式内固定系统治疗45例股骨干粉碎性骨折患者，在治疗后早期进行功能锻炼，评估患者的治疗时间、出血量、骨折愈合时间及肢体功能恢复情况等。分析桥接组合式内固定系统在股骨骨折治疗过程中的生物力学特点，并与髓内钉和接骨板进行比较。 　　结果与结论：所有患者随访12-24个月，平均随访18个月。桥接组合式内固定系统的手术时间1.0-2.5 h，平均1.5 h；出血量100-400 mL，平均出血量200 mL；骨折愈合时间4.0-6.0个月，平均4.5个月。手术后无伤口感染、骨折不愈合、内固定松动、断裂等严重并发症。肢体功能评价，优40例，良2例，中3例，优良率为93.3%。桥接组合式内固定系统符合骨折生物力学内固定的特性，是集锁定钢板、交锁髓内钉和外固定支架优势为一体的桥接组合式内固定系统，在股骨骨折的治疗上具备操作简单、适应证广、临床疗效满意的特点，是股骨干粉碎骨折治疗的一种新选择。
배경：수내정、강판화외고정지가재고골간분쇄성골절적치료상각유우세화국한성。목적：탐토교접조합식내고정계통치료고골간분쇄성골절적효과이급생물역학특점。 　　방법：응용교접조합식내고정계통치료45례고골간분쇄성골절환자，재치료후조기진행공능단련，평고환자적치료시간、출혈량、골절유합시간급지체공능회복정황등。분석교접조합식내고정계통재고골골절치료과정중적생물역학특점，병여수내정화접골판진행비교。 　　결과여결론：소유환자수방12-24개월，평균수방18개월。교접조합식내고정계통적수술시간1.0-2.5 h，평균1.5 h；출혈량100-400 mL，평균출혈량200 mL；골절유합시간4.0-6.0개월，평균4.5개월。수술후무상구감염、골절불유합、내고정송동、단렬등엄중병발증。지체공능평개，우40례，량2례，중3례，우량솔위93.3%。교접조합식내고정계통부합골절생물역학내고정적특성，시집쇄정강판、교쇄수내정화외고정지가우세위일체적교접조합식내고정계통，재고골골절적치료상구비조작간단、괄응증엄、림상료효만의적특점，시고골간분쇄골절치료적일충신선택。
BACKGROUND:Intramedul ary nail, plate and external fixation in treatment of comminuted fracture of shaft of femur have their advantages and limitations. OBJECTIVE:To explore the effects and biomechanical features of bridge combined fixation system in treatment of comminuted fracture of shaft of femur. METHODS:Bridge combined fixation system was used to treat 45 patients with comminuted fracture of shaft of femur. Functional exercise was performed in early stage of treatment. Therapeutic time, bleeding amount, fracture healing time and the recovery of limb function were evaluated. Biomechanical features of the bridge combined fixation system were analyzed during the treatment of comminuted fracture of shaft of femur, and compared with intramedul ary nail and bone plate. RESULTS AND CONCLUSION:Al patients were fol owed up for 12-24 months, averagely 18 months. The therapeutic time of the bridge combined fixation system was 1.0-2.5 hours, averagely 1.5 hours. Bleeding amount was 100-400 mL, averagely 200 mL. Fracture healing time was 4.0-6.0 months, averagely 4.5 months. After treatment, no severe complications, such as wound infection, fracture disunion, internal fixator loosening or breakage, were observed. Limb function evaluation showed:excellent in 40 cases, good in 2 cases, average in 3 cases, with an excellent and good rate of 93.3%. The bridge combined fixation system was accorded with the feature of fracture biomechanical fixation, and a blend of locking plate, interlocking intramedul ary nail and external fixator. For the treatment of femoral fracture, the bridge combined fixation system is operated easily, has wide indication and satisfactory clinical therapeutic effects, and is a new choice for treatment of comminuted fracture of shaft of femur.