镍钛记忆合金环抱器治疗多发性肋骨骨折的临床观察

Clinical observation of titanium-nickel alloy embracing holder fixation aided for multiple rib fracture

目的探讨应用镍钛记忆合金环抱器治疗多发肋骨骨折的方法和临床疗效。方法 2010年1月至2012年8月徐州市中心医院胸外科切开复位骨折肋骨,应用镍钛记忆合金环抱器内固定治疗多发肋骨骨折56例,分析手术疗效和并发症情况。结果本组56例患者手术均顺利完成,手术时间1～3h,术中出血50～100mL。术后反常呼吸消失,呼吸功能明显改善,呼吸痛立即缓解,仅有切口疼痛。术后出现胸壁血肿2例,肺部感染6例,无切口感染及其他并发症发生。住院时间(26.53±0.51)d。术后1个月复查胸部X线显示无骨折移位,无环抱器松动,无胸廓塌陷畸形。随访6～24个月,所有患者无明显胸壁异物感,无顽固性胸痛、异物排斥反应、骨质疏松及切口感染等并发症。结论应用镍钛记忆合金环抱器进行内固定,手术简单易行,手术时间短,创伤小,固定牢固,疗效显著,是治疗多发肋骨骨折可行的方法。

Objective To investigate the technique and therapeutic effects of titanium-nickel alloy embracing holder fixation aided for multiple rib fracture. Methods Fifty-six cases were managed by internal fixation of ribs with titanium-nickel alloy embracing holder from January 2010 to August 2012 at Thoracic Surgery Department of Xuzhou Central Hospital. Operation efficacy and complications were analyzed. Results Fifty-six patients were all operated smoothly. The total operation time was 1 to 3 hours and the amount of bleeding was 50 to 100 mL. The phenomenon of paradoxical breathing was disappear, and the respiratory function was improved. The pain of breathing was decreased, and the patients can only felt the pain of the cuts. After the operation, thoracic wall hematoma was detected in two patients, and pulmonary infection in six patients, but none had wound infection and other complications. Length of hospital stay was （26.53 ±0. 51 ） days. After one month, chest X-ray showed fracture stable, holder firmly, chest wall retrieved. All patients were followed up for 6 to 24 months, none presented intractable chest pain, wound infection, osteoporosis, foreign body rejection or sensation. Conclusions Titanium-nickel alloy embracing holder fixation aided is convenient, and it can reduce the surgical time, keep minimally invasive, stable and effective. It＇ s a feasible method for multiple rib fracture.