可消毒止血带在股骨干中下段骨折切开复位内固定术中的应用价值

Application value of sterilizable tourniquet in open reduction internal fixation for mid-lower femoral shaft fractures

目的探讨可消毒止血带在股骨干中下段骨折切开复位内固定术中的应用价值。方法回顾性分析同一手术组使用（试验组，45例）和不使用（对照组，45例）可消毒止血带行股骨干中下段骨折切开复位内固定术的资料。结果2组切口均一期愈合，无血管神经损伤和感染发生。患者均获随访12～32个月，平均16．7个月。骨折均愈合，无内固定断裂、再骨折和骨不连等并发症发生。2组骨折愈合时间差异无统计学意义（P〉0．05）。末次随访时，试验组膝关节功能HSS评分优14例、良31例，对照组优13例、良32例，2组HSS评分优良率均为100％，差异无统计学意义（P〉0．05）。试验组手术时间、术中出血量、输血量和实际总失血量均小于对照组，差异有统计学意义（P〈0．05）。结论使用可消毒止血带行股骨干中下段骨折切开复位内固定术对患者膝关节功能恢复、骨折愈合时间和并发症发生率无影响，但可以有效减少出血和输血量．缩短手术时间。

Objective To explore the application value of sterilizable tourniquet in open reduction internal fixation for midlower femoral shaft fractures. Methods A retrospective study of using （experimental group, 45 cases） and not using（control group, 45 cases） sterilizable tourniquet in open reduction internal fixation for mid-lower femoral shaft fractures by the same operator group. Results Operative incision of both groups were primary healing, without neurovascular injury and infection. All patients were followed-up for 12 to 32 months（mean 16.7 months）. All cases got bone union, there was no breakage of internal fixation, refracture, nonunion or.other complications. There was no significant difference in fracture healing time between the two groups （P 〉0.05）. At the last follow-up, according to the HSS score, 14 cases were graded as excellent, 31 as good in experimental group, 13 cases were graded as excellent, 32 as good in control group, with excellent and good rate of 100% in both two groups, there was no significant difference （P 〉0.05）. The operation time, amount of intraoperative bleeding, amount of blood transfusion and actual total amount of bleeding were less in the experimental group than those in the control group, there were significant differences （P 〈0.05）. Conclusion Open reduction internal fixation for mid-lower femoral shaft fracture with use of sterilizable tourniquet has advantages of reducing bleeding and blood transfusion, shortening operation time, although it has no effects on excellent and good rate, healing time and complications.