应用可吸收钉棒治疗关节内骨折

TREATMENT OF INTRA-ARTICULAR FRACTURE WITH ABSORBABLE SCREWS AND RODS

目的探讨可吸收钉、棒治疗关节内骨折的效果。方法1998年6月～2004年8月,应用自身增强-聚乙酯(self-reinforcedpolyglycolicacid,SR-PGA)、自身增强-聚丙酯(self-reinforcedpoly-L-Lacticacid,SR-PLLA)可吸收螺钉、棒,手术治疗关节内骨折35例,其中男30例,女5例。年龄4～62岁。均为关节内或关节周围松质骨骨折。手术时间为伤后3h～29d。应用SR-PGA全螺纹钉9枚,SR-PLLA拉力螺钉26枚,SR-PLLA固定棒15枚。术后行骨牵引或石膏外固定。结果患者术后获随访3～60个月,平均28个月,伤口均期愈合;骨折于1～3个月内达临床愈合,无再移位、感染及局部积液。患者关节功能恢复满意。根据美国骨科协会(AASO)关节功能评价:优26例,良7例,可1例,差1例,优良率94.3%。结论可吸收内固定钉、棒治疗关节内及关节周围骨折,免除了患者二次手术取出内固定物的痛苦,是一种有效和较为理想的方法。

Objective To assess the treatment effect of intra-articular fracture with absorbable screws and rods. Methods From June 1998 to August 2004, 35 patients with intra-articular fracture were treated by absorbable screws and rods made of self-reinforcedpolyglycolicacid （SR-PGA） and self-reinforcedpoly-L-Lacticacid （SR-PLLA）. Of 35 patients, 30 were males and 5 were females （aged from 4 to 62 years）. All cases had intra-articular or periarticular fracture. The interval between injury and operation was 3 hours to 29 days. Fracture were fixed with full thread screws of SR-PGA in 9 cases, with tensile screws of SR-PLLA in 26 cases, with rods of SR-PLLA in 15 cases. Bone traction or plaster external fixation were carried out postoperatively. Results The patients were followed from 3 months to 60 months with an average of 28 months. The wounds healed by first intention, and the healing time of bone was 1-3 months. No dislocation, infection and local effusion occurred. Functional recovery was satisfactory. According to AASO articular function standard, the results were excellent in 26 cases, good in 7 cases, fair in 1 case, and poor in 1 case ; the total excellent and good rate was 94.3%. Conclusion Internal fixation of absorbable screws and rods are a perfect procedure in treating intra-articular and periarticular fracture, which can avoid the pain of taking out internal fixation materials because of second operation.