四种内固定技术治疗胸腰椎骨折脱位的临床评估

Treatment of Thoracolumbar Fracture and Dislocation with Four Kinds of Internal Fixation

评价Harrington棒 ,Dick钉 ,Steffee钢板 ,S F内固定治疗胸腰椎骨折脱位的疗效。方法应用不同内固定技术治疗胸腰椎骨折脱位 48例 ,其中Har rington棒 14例 ,Dick钉 10例 ,Steffee钢板 16例 ,S F内固定 8例。平均随访 2 8个月。结果所有脊柱骨折均有明显复位 ,皆无感染及或神经根症状加重。神经功能恢复情况 :FrankleA级 6例 2例恢复到B级 ;B级 10例中 5例恢复到E级 ,5例恢复到D级 ;C级 16例中 6例恢复到D级 ,10例恢复到E级 ;D级 10例全部恢复到E级 ;E级 10例均能恢复原有工作。结论S F内固定器在治疗胸腰椎骨折脱位中椎体高度恢复满意。Harrington棒对上胸椎或有严重的侧前方脱位和多节段的胸腰椎骨折尤为有效。各种内固定器械各有其优缺点 ,应掌握各自适应证。

ObjectiveTo evaluate the clinical effects of Harrington′s rod,Dick′s nail,Steffee′s plate and S-F device for treatment of thoracolumbar fracture and dislocation.MethodsForty-eight cases of thoracolumbar fracture and dislocation were treated with four kinds of internal fixation(Harrington′s rod in 14 cases,Dick′s nail in 10 cases,Steffee′s plate in 16 cases and S-F device in 8 cases).All patients were followed-up for 28 months averagely.ResultsAll fractures of spines were improved significantly,no infection and aggravation of neural symptoms occurred.According to Frankle′s classification of stages,patients in each stage upgraded more or less.For instance,all ten cases of Grade D recovered to Grade E and all ten cases of Grade E went back to original work.ConclusionsS-F device shows satisfactory effect for restoring the height of vertebral body,and Harrington′s rod is especially fit for treatment of severe lateroanterior dislocation of superior thoracic vertebrae and multi-segmental fracture of thoracolumbar vertebrae.It is important to be familiar with the advantages and disadvantages of each internal fixation device. [