胸骨骨折的两种手术方式对比研究

A comparative study of two operations of sternal fracture

目的比较钢丝内固定术、钛胸骨固定系统固定术治疗胸骨骨折的效果。方法30例胸骨骨折病例中分别采用钢丝内固定术20例（钢丝内固定组）和钛胸骨固定系统固定术10例（钛胸骨固定组），将两种手术方式的一般情况、围手术期情况、并发症及治疗效果等进行比较。结果30例均顺利完成手术，钛胸骨固定组与钢丝内固定组手术时间分别为（67．0±7．9）、（90．0±8．6）min，术中出血量分别为（11．0±5．4）、（48．0±8．4）ml，引流时间分别为（0．5±0．4）、（1．9±0．7）d，引流量分别为（1．9±1．3）、（19．0±4．6）ml，术后住院时间分别为（2.3±0．5）、（6．9±0．9）d，术后疼痛时间分别为（1．5±0．5）、（3．8±1．1）d，两组比较差异均有统计学意义（P〈0．05）。钢丝内固定组切口感染、延迟愈合或不愈合、再骨折、内固定断裂或移位的发生率分别为5％（1／20）、5％（1／20）、5％（1／20）、10%（2／20），钛胸骨固定组均为0，两组手术并发症发生率比较差异均有统计学意义（P〈0．05）。结论钛胸骨固定系统固定术与钢丝内固定术相比具有操作简单、固定稳定、骨折愈合率高、并发症少等优点，是治疗胸骨骨折的理想方法。

Objective To compare the efficacies of the treatment of sternal fracture with wire fixation and the titanium sternal fixation system. Methods Thirty patients with sternal fracture from May 2003 to July 2009 were followed up. Among them,there were 20 patients with wire fixation （wire fixation group）, 10 patients with the titanium sternal fixation system （titanium sternal fixation system group）. The conditions before, during and after operation,complications and effects were compared to evaluate the efficacies of titanium sternal fixation system. Results The operative time of titanium sternal fixation system group and wire fixation group were （67.0 ± 7.9） rain and （90.0 ±8.6） rain,the blood loss were （ 11.0 ±5.4） ml and （48.0 ±8.4）ml,the duration of drainage were （0.5 ±0.4） days and （ 1.9 ±0.7） days,the amount of drainage were （1.9 ±1.3） ml and （19.0 ±4.6） ml, the average hospitalized days were （2.3 ±0.5） days and （6.9 ±0.9 ） days, the duration of pain were （ 1.5 ±0.5 ） days and （ 3.8 ±1.1 ） days, there were all significant difference between two groups （P 〈 0.05）. The rates of wound infection, delayed union or nonunion, re-fracture, plate fracture or plate shift of wire fixation group were 5 % （ 1/20）, 5% （ 1/20）, 5% （ 1/20）, 10% （2/20）. But the rates of titanium sternal fixation system group were 0, there were all significant difference between two groups （P 〈 0.05）. Conclusion The treatment of sternal fracture with titanium sternal fixation system is a simple and stable fixation, high bone union rate and few complications, especially for the sternal fracture.