摘要
目的:观察缓降解聚酰胺可吸收螺钉在关节部位新鲜骨折内固定中的临床应用效果。方法:选择2001-03/2005-12中山大学附属第二医院骨科病区住院的各种关节部位新鲜骨折患者46例,男36例,女10例;年龄1663岁。其中肱骨内髁骨折7例,肱骨外髁骨折6例,肱骨大结节骨折5例,桡骨远端骨折7例,股骨外髁撕裂骨折3例,胫骨内、外侧平台撕裂骨折5例,内踝骨折5例,外踝骨折4例,后踝骨折4例。骨折后1～6d,平均3d。①所采用的缓降解聚酰胺可吸收螺钉(深圳昌华生物医学工程有限公司提供),为全螺纹或半螺纹拉力螺钉,直径为2.7mm、3.5mm和4.5mm,长度20～70mm。②手术方法同传统AO内固定术。术后结合早期肢体功能康复与锻炼。③治疗效果以末次随访患者肢体局部功能恢复情况评估,分为优、良、差。疼痛采用目测类比评分法(VAS)评定,0分为无痛,10分为剧痛。结果:除1例失访外,45例获随访,随访期3～21个月,其中随访3个月1例,6个月5例,9个月11例,12个月13例,15个月8例,18个月5例,21个月2例,平均随访12月。依据末次随访结果评估治疗效果。①患者肢体局部功能恢复情况:优42例,骨折均达解剖复位,关节功能基本正常,活动时目测类比评分为0分,伤口一期愈合;良3例,骨折功能复位,关节功能基本正常,仅有轻度功能障碍,运动过多时有轻度疼痛(目测类比评分为一二分)。②不良事件及副反应:术后病例复查无螺钉变形、断裂而引发骨折再移位或骨折不愈合情况,也无感染、积液和特异性炎症反应现象。结论:国产缓降解聚酰胺可吸收螺钉治疗新鲜关节部位骨端骨折患者术后肢体功能恢复状态较好,且无明显不良反应。
AIM： To assess the clinical effect of brady-degradable polyamide absorbable screws on the treatment of peri- and intra-articular fracture.METHODS： From March 2001 to December 2005, 46 inpatients with peri- and intra-articular fresh fraetures including 36 males and 10 females; aged 16 to 63 years, in the Orthopaedics Department of the Second Affiliated Hospital of Sun Yat-sen University were selected. The fractures were classified according to the site including 7 medial condyle of the humerus, 6 lateral condyle of the humerus, 5 greater tuberosity of humerus, 7 distal radius, 3 lateral condyle of femur, 5 medial and lateral tibial plateau, 5 medial malleolus, 4 lateral malleolus and 4 posterial malleolus, all the fractures lasted 1-6 days, the average 3 days. （1） The brady-degradable polyamide absorbable Screws （provided by Shenzhen Changhua Biomedical Engineering Co., Ltd.） were full or partial thread lag screws with 2.7 mm, 3.5 mm and 4.5 mm in diameter and 20-70 mm in length. （2）The traditional AO internal fixation combined with limbs functional rehabilitation and exercise in early stage was used in operation. （3）The curative effect was evaluated by the limbs local functional recovery status in the last follow up, which was classified into excellent, good or poor. The pain was evaluated by visual analogue scale （VAS）, 0 score meant painless and 10 scores meant acute pain. RESULTSt Forty-five out of the forty-six cases were followed up for 3 to 21 months, among which 1 case for 3 months, 5 for 6 months, 11 for nine months, 13 for 12 months, 8 for 15 months, 5 for 18 months, 2 for 21 months, averagely twelve months. The overall clinical outcomes were assessed according to the result in the last follow-up. （1）the recovery state of limbs local function： There were 42 cases of excellent, whose fracture were repositioned, the articular function recovered, and the score in the VAS was 0, the wound was healed in primary; there were 3 cases of good, whose articular function recovered nearly, with only mild functional disturbance, and the light pain appeared when extensive exercise, the score in the VAS were 1-2 scores. （2） Bad events and side effect： No complications such as screw migration or breaking down, nonunion or malunion, infection, fLuidify or special inflammatory reaction was observed. CONCLUSION： The use of domestic brady-degradable polyamide absorbable screws is a safe and perfect procedure for peri- and intraarticular fractures without any Obvious adverse effect.
出处
《中国临床康复》
CSCD
北大核心
2006年第25期126-128,共3页
Chinese Journal of Clinical Rehabilitation
