摘要
目的：探讨有限剥离骨膜对老年人股骨干骨折的疗效和安全性。方法：应用钢板固定治疗老年人股骨干骨折45例,男32例,女13例;年龄58~81岁,平均（69.5±7.1）岁。分别采用常规骨膜剥离方法或有限（微创术式）骨膜剥离后,行复位和钢板固定。其中有限骨膜剥离（A组）27例,按Anderson分型：Ⅰ型15例,Ⅱ型8例,Ⅲ型4例。常规骨膜剥离18例（B组）,Ⅰ型8例,Ⅱ型5例,Ⅲ型5例。分别对两组骨痂形成状况、骨折愈合时间及并发症进行比较。结果：术后随访10~24个月,平均18个月,有限骨膜剥离方法骨痂形成状况、骨折愈合时间与常规骨膜剥离方法相比差异有统计学意义（P〈0.05）,A组优于B组;骨折延迟愈合、非感染性骨不连及骨折畸形愈合等并发症的发生差异亦有统计学意义（P〈0.01）,B组并发症发生率高于A组。结论：有限骨膜剥离钢板固定治疗老年人股骨干骨折是一种安全、有效的方法。与常规骨膜剥离方法相比,有限骨膜剥离具有骨折愈合时间短、并发症少等优点。
Objective：To explore the therapeutic effects and safety of limited periosteal stripping on the union of femoral shaft fractures in the old people.Methods：A retrospective study was undertaken in 45 old patients with femoral shaft fractures.Among the patients,32 patients were male and 13 patients were female,aged from 58 to 81 years with a mean age of 69.5±7.1 years.The patients were treated with traditional periosteal stripping or limited（micro trauma）periosteal stripping followed by reduction and internal fixation with a plate.Twenty-seven patients were treated with limited periosteal stripping,including（according to Anderson classification） Type Ⅰ（n=15）,TypeⅡ（n=8）,Type Ⅲ（n=4）.Eighteen patients were treated with traditional periosteal stripping,including TypeⅠ（n=8）,TypeⅡ（n=5）,TypeⅢ（n=5）.The porosis,healing time of fracture and complications were compared between the two groups.Results：All patients were followed-up postoperatively with an average duration of 18 months（ranged 10 to 24 months）.The porosis and time of union of fracture between the two groups had significant differences（P〈0.05）,and the results of Group A were better than that of Group B;there was also significant difference in the occurrence of delayed union,aseptic non-union and malunion of the fracture between the two groups（P〈0.01）,and the incidence of complications in Group B was higher than that in Group A.Conclusion：The limited periosteal stripping with plate fixation is a safety and effective procedure that offers significant advantages for femoral shaft fractures in old people：shorter healing-time and fewer complications compared with traditional periosteal stripping.
出处
《中国骨伤》
CAS
2007年第12期840-841,共2页
China Journal of Orthopaedics and Traumatology
关键词
股骨骨折
骨折愈合
骨膜
骨折固定术
内
老年人
Femoral fractures
Fracture healing
Periosteum
Fracture fixation,internal
Aged
