可吸收肋骨钉与记忆合金接骨板在治疗多根多处肋骨骨折中的应用

Comparison of Absorbable Screws and Memory Alloy Plates in the Operative Stabilization of Multiple Rib Fractures

目的:比较采用可吸收肋骨钉与记忆合金接骨板内固定治疗肋骨骨折的疗效。方法:胸部外伤致多发肋骨骨折的患者58例,入院后均经胸部影像学检查确诊为多根多处肋骨骨折并重叠移位。对其中38例患者采用可吸收肋骨钉行肋骨骨髓腔内固定术(研究组),对其余20例患者采用记忆合金接骨板行内固定术(对照组)。比较两组的疗效。结果:两组均无死亡病例,研究组出现3例胸腔积液,3例肺部感染;对照组出现2例肺部感染,3例切口感染;所有患者经对症处理后均痊愈。两组的手术时间、固定肋骨根数、住院时间及并发症发生情况差异均无统计学意义(P>0.05);与对照组相比,研究组术中失血量少、术后呼吸机使用时间短、术后疼痛减轻、术后下床活动早,结果差异有统计学意义(P<0.05)。术后6个月复查胸部X线片,两组均无骨折再移位;术后1～2年对照组有14例患者行等二次手术以取出内固定物。结论:采用可吸收肋骨钉治疗多发性肋骨骨折,疗效优于记忆合金接骨板。

Objective：To compare the effect of operative stabilization of multiple rib fractures by using absorbable screws and memory alloy plates. Methods： A total of 58 patients with multiple rib fractures have been enrolled in this study. All patients have been confirmed multiple ribs fractures by imaging examination. Among them, 38 cases underwent internal fixation with absorbable screws （study group）, and the other 20 cases underwent internal fixation with memory alloy plates （control group）. The efficacy of the two groups were compared. Results： No death occurred in both groups. There were 6 cases of complications in the study group and 5 cases in the control group. The operation time, the number of fixed ribs, the length of stay, and the rate of complications in the study group were similar to the control group. The blood loss during the operation, the time for mechanical ventilation postoperatively and the postoperative pain were less in the study group than in the control group, and pa- tients in the study group had out-of-bed activity earlier than those in the control group. At 6 months after the operation, no dis- placement of fractures had been found in both groups. Fourteen cases in the control group underwent a secondary surgery to take out the internal fixation materials within one to two years after the first operation. Conclusions： Using absorbable screws to stabilize multiple rib fractures has good curative effects.