桥接组合系统与锁定钢板固定股骨干骨折比较

Bridge combined fixation system versus interlocking plate for internal fixation of femoral shaft fractures

[目的]采用桥接组合式内固定系统治疗股骨干骨折,并与锁定钢板进行比较,分析其安全性与有效性.[方法]回顾性分析2016年9月-2019年11月本院开放复位内固定治疗成人股骨干骨折80例患者的临床资料.按术前医患沟通结果,42例采用桥接组合式内固定系统内固定,38例采用锁定加压钢板内固定.比较两组患者围手术期情况、随访期指标及影像学结果.[结果]两组手术均顺利完成,两组患者均无血管、神经损伤等严重并发症.桥接组手术时间、切口长度、术中出血量、术中透视次数、术后引流量及住院时间均显著优于钢板组(P<0.05).桥接组患者的下地行走时间及完全负重时间均显著早于钢板组(P<0.05).随术后时间推移,两组患者髋ROM、Harris评分,膝ROM、HSS评分均显著增加(P<0.05);术后3个月和末次随访时,桥接组患者的髋伸屈ROM、Harris评分,膝伸屈ROM及HSS评分均显著优于钢板组(P<0.05).影像方面,末次随访时桥接组患者的侧方移位、成角畸形及短缩畸形的矫正方面显著优于钢板组(P<0.05),桥接组骨折愈合时间显著早于钢板组(P<0.05).[结论]本研究表明,桥接组合式内固定治疗股骨干骨折的效果优于锁定钢板.

[Objective]To explore the safety and effectiveness of bridge combined internal fixation system by comparison with the interlocking plate in the treatment of femoral shaft fractures.[Methods]A retrospective study was conducted on 80 patients who underwent open reduction and internal fixation for femoral shaft fractures in our hospital from September 2016 to November 2019.According to the consequences of preoperative patient-doctor communication,42 patients had fractures fixed with the bridge system,while the other 38 patients received conventional fixation with interlocking plate.The documents,including perioperative conditions,follow-up results and radio-graphic evaluation,were compared between the two groups.[Results]All the patients in both groups received successful surgical procedures without serious complications,such as neurovascular injuries.The bridge group proved significantly superior to the plate group in terms of operation time,incision length,intraoperative blood loss,intraoperative fluoroscopy,postoperative drainage and hospital stay(P<0.05).The bridge group resumed walking and full weight bearing activity significantly earlier than the plate group(P<0.05).The hip range of motions(ROMs)and Harris score,as well as the knee ROMs and HSS score significantly increased over time postoperatively in both groups(P<0.05),which in the bridge group was significantly superior to the plate group at 3 months and the latest follow-up(P<0.05).Regarding to radiographic assessment,the bridge group was significantly superior to the plate group in terms of restoration of the low limb alignment at the latest follow up(P<0.05),and the time to get fracture healing(P<0.05).[Conclusion]In this study,the bridge combined internal fixation system does achieve more satisfactory clinical outcomes than conventional plate for femoral shaft fractures.