37例氟骨症患者长管状骨骨折愈合临床分析

Analysis of long tubular bone fracture healing in 37 patients with osteofluorosis

目的探讨氟骨症骨折分型与骨折愈合的时间关系。方法采用回顾性分析方法，收集37例氟骨症和24例非氟骨症长管状骨骨折患者的临床资料。氟骨症患者根据临床X线诊断，分为硬化型组和疏松型组，非氟骨症长管状骨骨折患者为对照组。所有患者均进行过手术治疗（切开复位，钢板内固定），比较硬化型和疏松型对骨折愈合时间的影响。结果硬化型组、疏松型组、对照组骨折愈合时间分别为（18．4±5．3）、（24．5±5．1）、（17．6±3．8）周，组间比较差异有统计学意义（F=4．30，P〈0．05）。其中疏松型组与对照组比较，差异有统计学意义（q=2．34，P〈0．05）；疏松型组骨折愈合时间明显长于硬化型组，二者比较差异有统计学意义（q=2．51，P〈0．05）。硬化型组、疏松型组、对照组骨折按期愈合率分别为73．1％（19／26）、54．5％（6／11）、75．0％（18／24），组间比较差异有统计学意义（Х^2=3．67，P〈0．05）；疏松型组骨折按期愈合率低于硬化型组和对照组（Х^2值分别为3．12、3．36，P〈0．05）。硬化型组、疏松型组、对照组骨折延迟愈合率分别为26．9％（7／26）、45．5％（5／11）、25．0％（6／24），组间比较差异有统计学意义（Х^2=4．07，P〈0．05）；疏松型组骨折延迟愈合率高于硬化型组和对照组（Х^2值分别为3．87、3．95，P〈0．05）。结论疏松型氟骨症患者骨折愈合时间相对延长，可能是骨量过于缺乏的原因。

Objective To study the correlations between bone fracture types and healing time in patients with osteofluorosis. Methods Thirty-seven patients with osteofluorosis and long tubular bone fracture were diagnosed in accordance with radiogram retrospectively. The fractures were divided into two groups： sclerotic and osteoporotie. Twenty four fractured patients with non osteofluorosis were included in the study as controls. All of the patients had operation（open reduction and nickelelad internal fixation）. Fracture healing in patients with sclerotic and osteoporotie groups was compared with the control group after operation. Results There were notable differenees（F = 4.30,P 〈 0.05） in term of fracture healing time among the three groups [ sclerotic group ： （ 18.4 ± 5.3）weeks ; osteoporotic group ： （24.5 ± 5.1 ）weeks ; control group： （ 17.6 ± 3.8）weeks ]. Notably, there were significant differences between the osteoporotic and control groups（q = 2.34,P 〈 0.05）, and between sclerotic and osteoporotie groups（q = 2.51, P 〈 0.05）. The healing time of the osteoporotie group was longer than that of sclerotic group. The constituent ratios of fracture healing in sclerotic, osteoporotic and control groups were 73.1% （ 19/26 ）, 54.5% （6/11 ）, 75.0% （ 18/24 ） respectively, and the differences among the three groups were statistically significant（Х^2 = 3.67,P 〈 0.05）. The healing rate of the osteoporotic group was lower than that of sclerotic and control groups（Х^2 = 3.12, 3.36, all P 〈 0.05）. The constituent ratios of healing in the sclerotic, osteoporotic and control groups were 26.9%（7,/26）,45.5% （5/11）,25.0%（6/24）, respectively, and there differences among the three groups were statistically significant （Х^2 = 4.07 ,P 〈 0.05）. The delayed healing rate of the osteoporotie group was higher than those of the sclerotic and control groups（Х^2 = 3.87,3.95, all P 〈 0.05 ）. Conclusions Fracture healing time of osteoporotic osteofluorosis after fracture is longer than normal, and the cause might be the loss of bone mass.