| 桥接系统治疗严重粉碎性股骨骨折 |
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Received:August 20, 2019
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| 作者 | Author | 单位 | Unit | E-Mail |
| 郭龙 |
GUO Long |
浙江省湖州市福音医院 陆军第72集团军医院骨二科, 浙江 湖州 313000 |
Department of Orthopaedics, Huzhou Gospel Hospital, the 72 nd Army Hospital of the PLA, Huzhou 313000, Zhejiang, China |
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| 朱新宏 |
ZHU Xin-hong |
浙江省湖州市福音医院 陆军第72集团军医院骨二科, 浙江 湖州 313000 |
Department of Orthopaedics, Huzhou Gospel Hospital, the 72 nd Army Hospital of the PLA, Huzhou 313000, Zhejiang, China |
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| 于凤宾 |
YU Feng-bin |
浙江省湖州市福音医院 陆军第72集团军医院骨二科, 浙江 湖州 313000 |
Department of Orthopaedics, Huzhou Gospel Hospital, the 72 nd Army Hospital of the PLA, Huzhou 313000, Zhejiang, China |
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| 赖爱宁 |
LAI Ai-ning |
浙江省湖州市福音医院 陆军第72集团军医院骨二科, 浙江 湖州 313000 |
Department of Orthopaedics, Huzhou Gospel Hospital, the 72 nd Army Hospital of the PLA, Huzhou 313000, Zhejiang, China |
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| 陶德刚 |
TAO De-gang |
浙江省湖州市福音医院 陆军第72集团军医院骨二科, 浙江 湖州 313000 |
Department of Orthopaedics, Huzhou Gospel Hospital, the 72 nd Army Hospital of the PLA, Huzhou 313000, Zhejiang, China |
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| 陈冰 |
CHEN Bing |
浙江省湖州市福音医院 陆军第72集团军医院骨二科, 浙江 湖州 313000 |
Department of Orthopaedics, Huzhou Gospel Hospital, the 72 nd Army Hospital of the PLA, Huzhou 313000, Zhejiang, China |
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| 黄飞 |
HUANG Fei |
浙江省湖州市福音医院 陆军第72集团军医院骨二科, 浙江 湖州 313000 |
Department of Orthopaedics, Huzhou Gospel Hospital, the 72 nd Army Hospital of the PLA, Huzhou 313000, Zhejiang, China |
huangfei651012@sina.com |
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| 期刊信息：《中国骨伤》2020年33卷，第4期，第332-336页 |
| DOI：10.12200/j.issn.1003-0034.2020.04.009 |
| 基金项目:国家卫计委科研项目（编号：W2015QJ042） |
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目的：探讨应用桥接系统治疗严重粉碎性股骨骨折的临床疗效。
方法：2016年3月至2018年10月收治严重粉碎性股骨骨折患者50例，男35例，女15例，年龄48~72（54.6±8.7）岁；均为股骨干粉碎性骨折，合并股骨近端骨折16例，远端骨折7例；均为单侧骨折，左侧23例，右侧27例；受伤至手术时间5~60（26.7±13.3） h。致伤原因：交通意外12例，高处坠落35例，意外摔伤3例。采用桥接组合式内固定系统治疗，分析手术效果和骨折愈合情况。
结果：50例患者的手术均成功，无更改为其他固定术式，手术时间（75.8±12.3） min，出血量（356.4±64.8） ml，无严重术后并发症如感染、内固定移位、再骨折、骨折不愈合等。术后随访6~36个月，以Warden评分评价骨折愈合，随着观察时间延长，Warden评分逐渐增加，骨性愈合时间（5.5±0.9）个月。术后采用Harris评分和HSS评分分别评估髋膝关节功能，随着时间延长，Harris和HSS均逐渐升高，术后6个月Harris评分83.5±11.2，HSS评分79.7±10.5。随访期间无严重并发症发生如内固定移位、再骨折、骨折不愈合、下肢深静脉血栓形成等。
结论：桥接组合式内固定系统治疗严重粉碎性股骨骨折有较好的安全性和有效性；只要严格掌握局部解剖和生物力学要求，结合影像学充分评估手术风险，可实现较好的固定效果，手术创伤小、并发症少、操作简便，相信有较广泛的应用潜力。由于样本量和随访时间有限，未设置临床对照，研究结果仍需进一步前瞻性试验进行验证。 |
| [关键词]:股骨骨折 骨折,粉碎性 骨折固定术,内 |
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| Bridging system for severe comminuted femoral fracture |
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Abstract:
Objective: To explore the clinical effect of bridging system in the treatment of severe comminuted femoral fracture.
Methods: From March 2016 to October 2018,50 patients with severe comminuted femoral fracture including 35 males and 15 females,aged 48 to 72(54.6±8.7) years,were admitted. All cases were comminuted fractures of the femoral shaft,16 with proximal femur fractures and 7 with distal femur fractures. All cases were all unilateral fractures,23 on the left and 27 on the right. The time from injury to operation was 5 to 60 (26.7±13.3) hours. The cause of injury was traffic accident,12 cases with high fall,35 cases fell and 3 cases fell accidentally. The patients were treated with bridge combined internal fixation system,and the operative effect and fracture healing were analyzed.
Results: The operation was successful in all patients. There was no change to other fixed operation. The operation time was (75.8±12.3) min,the amount of bleeding was(356.4±64.8) ml,and there was no serious postoperative complications such as infection,internal fixation displacement,re fracture and nonunion. After 6 to 36 months follow-up,the fracture healing was evaluated by Warden's score. With the extension of observation time,Warden's score gradually increased,and the time of bone healing was(5.5±0.9) months. Harris score and HSS score were used to evaluate the function of hip and knee joint respectively. With the extension of time,Harris score and HSS score increased gradually. Six months after operation,Harris score was 83.5±11.2,HSS score was 79.7±10.5. During the follow-up period,there were no serious complications such as internal fixation displacement,re-fracture,nonunion of fracture and deep vein thrombosis of lower extremity.
Conclusion: The bridge combined internal fixation system has better safety and effectiveness in the treatment of severe comminuted femoral fracture. As long as the requirements of local anatomy and biomechanics are strictly mastered and the operation risks are fully evaluated in combination with imaging,the better fixation effect can be achieved. The operation has less trauma,fewer complications and simple operation,which is believed to have a wider application potential. Due to the limited sample size and follow-up time,no clinical control was set up,the results of the study still need to be further verified by prospective trials. |
| KEYWORDS:Femoral fractures Fractures,comminuted Fracture fixation,internal |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 郭龙,朱新宏,于凤宾,赖爱宁,陶德刚,陈冰,黄飞.桥接系统治疗严重粉碎性股骨骨折[J].中国骨伤,2020,33(4):332~336 |
| 英文格式: | GUO Long,ZHU Xin-hong,YU Feng-bin,LAI Ai-ning,TAO De-gang,CHEN Bing,HUANG Fei.Bridging system for severe comminuted femoral fracture[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(4):332~336 |
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