镍钛形态记忆合金环抱器与重建钢板置入内固定治疗尺桡骨中段骨折的比较

Ni-Ti shape memory alloy embracing fixator versus reconstruction plate fixation in treatment of midshaft fractures of the ulna and radius

背景:重建钢板螺钉内固定的松动、钢板段裂是影响骨折愈合的最常见的原因。镍钛形态记忆合金环抱器由于具有优良的力学特性、生物相容性和低生物蜕变性使其在骨折内固定方面显示出极大的优越性。目的:比较镍钛形态记忆合金环抱器内固定与重建钢板内固定治疗有移位或粉碎性尺桡骨中段骨折的临床效果。方法:选择兰州大学附属第一医院骨科2004-04/2009-03收治的尺桡骨中段骨折患者56例,镍钛形态记忆合金环抱器内固定组26例,重建钢板内固定组30例。所有患者分别在内固定后第1,2,4,6,12个月随访,采用Anderson标准进行前臂功能优良率评定。结果与结论:与重建钢板相比,镍钛形态记忆合金环抱器内固定治疗有移位或粉碎性尺桡骨中段骨折操作简单、手术时间短、术中出血量少、切口小(P<0.05),适应证广,内固定后前臂功能恢复优良率高,可早期进行功能锻炼。两组住院时间、内固定取出时间、内固定后骨折愈合率差异无显著性意义。提示记忆合金环抱器内固定治疗有移位或粉碎性尺桡骨中段骨折的疗效优于重建加压钢板。

BACKGROUND：Screw loosening and plate breakage are common factors that affect fracture healing. Ni-Ti shape memory alloy embracing fixator has good mechanics,biocompatibility and low biodegeneration. OBJECTIVE：To compare the clinical outcome of Ni-Ti shape memory alloy embracing fixator and reconstruction plate fixation in treatment of displaced or comminuted midshaft fractures of the ulna and radius. METHODS：A total of 56 patients with displaced or comminuted midshaft fractures of the ulna and radius were surgically treated with either Ni-Ti shape memory alloy embracing fixator or reconstruction plate fixation between April 2004 and March 2009 in Department of Orthopedics,First Hospital of Lanzhou University. Twenty-six were treated with Ni-Ti shape memory alloy embracing fixator and 30 with reconstruction plate fixation. All patients were followed up from 1,2,4,6,12 months following internal fixation,and forearm function was evaluated using Anderson standards. RESULTS AND CONCLUSION：Compared with reconstruction plate fixation group,Ni-Ti shape memory alloy embracing fixator operating was simpler,took shorter operation time and less blood,and required smaller wound incision （P 0.05） with wide indications,high excellent and good rate of functional recovery,and early allow for functional exercise. However,there was no statistical difference in terms of hospital stay,time of removing fixation,bone union rate between two groups （P 0.05）. The Ni-Ti shape memory alloy embracing fixator is better than reconstruction plate fixation in treatment of midshaft fractures of the ulna and radius.