| 麻醉下手法牵引复位在胸腰椎爆裂骨折后路手术前的应用 |
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Received:September 06, 2005
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| 作者 | Author | 单位 | Unit | E-Mail |
| 钱宇 |
QIAN Yu |
绍兴市人民医院,浙江绍兴312000 |
Department of Orthopaedics,Shaoxin People’s Hospital,Shaoxing 312000,Zhejiang,China |
doctor120@hotmai.lcom |
| 徐国健 |
XU Guo-jian |
绍兴市人民医院,浙江绍兴312000 |
Department of Orthopaedics,Shaoxin People’s Hospital,Shaoxing 312000,Zhejiang,China |
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| 张军 |
ZHANG Jun |
绍兴市人民医院,浙江绍兴312000 |
Department of Orthopaedics,Shaoxin People’s Hospital,Shaoxing 312000,Zhejiang,China |
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| 金柏军 |
JIN Bai-jun |
绍兴市人民医院,浙江绍兴312000 |
Department of Orthopaedics,Shaoxin People’s Hospital,Shaoxing 312000,Zhejiang,China |
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| 期刊信息：《中国骨伤》2006年19卷，第5期，第269-271页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:探讨麻醉下手法牵引复位在胸腰椎爆裂骨折后路手术前应用的临床价值。
方法:胸腰椎骨折患者132例,男91例,女41例;骨折按Denis分型A型9例,B型68例,C型27例,D型16例,E型12例。伤椎节段位于T117例,T1243例,L154例,L225例,L1、L2联合损伤3例。术前伤椎Cobb角平均28.4°±7.5°。椎管占位率按Wolter指数,0级8例,1级66例,2级47例,3级11例。132例术前均在麻醉下应用手法牵引复位,再施行后路复位内固定手术,其中12例同时行椎管减压。
结果:获得有效随访132例,术前均手法复位使伤椎Cobb角平均改善16.9°(P<0.05),椎管占位率亦同时改善。伤椎骨性愈合时间为(5.4±1.8)个月,未发生断钉,脊髓神经损伤程度有所改善。
结论:麻醉下术前手法复位有助于伤椎Cobb角和椎管占位率的恢复,避免大角度器械复位和大距离的撑开,降低内固定的失败率。 |
| [关键词]:胸椎 腰椎 骨折 手法,骨科 外科手术 |
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| Manipulative reduction by anesthesia before posterior operation in treatment of thoracolumbar burst fracture |
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Abstract:
Objective:To evaluate the clinical effect of manipulative reduction by anesthesia before posterior operations in treatment of thoracolumbar burst fracture.
Methods:By the anesthesia,132 patients （91 male and 41 female） with thoracolumbar burst fracture were treated by manipulative reduction,then the posterior operations were performed,and 12 cases of them were depressed in spinal canal directly.In these 132 cases,according to Denis classification,there were 9 cases of type A,68 cases of type B,27 cases of type C,16 cases of type C and 12 cases of type E.Injuried segment were located in T 11 in 7 cases,T 12 in 43 cases,L1 in 54 cases,L2 in 25 cases and both of L1 and L2 in 3cases.Average preoperative Cobb angle was 28.4°±7.5°.According to Wolter spinal canal occupational ratio,there were 8 cases of 0 stage,66 cases of 1 stage,47 cases of 2 stage and 11 cases of 3 stage.
Results:In effective followed up of 132 cases,the Cobb angles of burst vertebrae were improved by manipulative reduction for 16.9° （P<0.05）,and the occupation rates of spinal canals were improved as well.The average time of burst vertebrae healing was for （5.4±1.8） months without internal fixation failure,and the nerve function were improved.
Conclusion:The manipulative reduction by anesthesia before the operation is helpful for the burst vertebral to improve the Cobb angle and the occupation rate of spinal canal,avoid the big angle and large distance reduction,and decrease the accidence of internal fixation failure. |
| KEYWORDS:Thoracic vertebrae Lumbar vertebrae Fractures Manipulation,orthopaedics Surgical operative,procedures |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 钱宇,徐国健,张军,金柏军.麻醉下手法牵引复位在胸腰椎爆裂骨折后路手术前的应用[J].中国骨伤,2006,19(5):269~271 |
| 英文格式: | QIAN Yu,XU Guo-jian,ZHANG Jun,JIN Bai-jun.Manipulative reduction by anesthesia before posterior operation in treatment of thoracolumbar burst fracture[J].zhongguo gu shang / China J Orthop Trauma ,2006,19(5):269~271 |
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