骨密度与骨折合并颅脑损伤患者骨折愈合的评价

背景：颅脑损伤患者下肢骨折愈合过程中，骨折周围新生骨形成加速现象在临床上较为常见。这种快速形成的骨痂或异位骨化是否是颅脑损伤合并下肢骨折患者的常见并发症，至今仍有争论。 目的：利用骨密度检测来评估创伤性脑损伤对股骨干骨折愈合的影响。 方法：纳入创伤性脑损伤合并股骨干骨折患者和单纯股骨干骨折患者各25例，以切开复位后钢板螺钉内固定。术后第6，12周行X射线测量骨痂体积。术后1，3，5周利用双能X射线骨密度测定仪测定两组患者骨折区骨密度值。 结果与结论：单纯股骨干骨折患者术后第12周较第6周骨痂体积明显增加。合并颅脑损伤患者术后第6，12周骨痂体积均有明显增加，且大于单纯骨折组骨痂体积。在第1，3，5周时骨折区骨密度值逐渐增大，并且高于同时间点单纯骨折组骨折区骨密度值。说明创伤性脑损伤可增加股骨干骨折愈合时的骨痂体积，提高骨折区骨密度值，缩短骨折愈合时间。

Evaluation of fracture healing in patients with fracture complicated by traumatic brain injury using bone mineral density tests

BACKGROUND: Many clinical reports have demonstrated that traumatic brain injury can accelerate fracture healing. But this phenomenon has not been assessed by bone mineral density. OBJECTIVE: To evaluate the effects of traumatic brain injury on fracture healing using bone mineral density tests. METHODS: A total of 25 patients with traumatic brain injury complicated by femoral shaft fracture and 25 patients with femoral shaft fracture were included. All patients underwent reduction and received internal fixation using steel plate with screws. At 6 and 12 weeks after surgery, callus volume was determined by X-ray examination. At 1, 3, and 5 weeks after surgery, bone mineral density value in the fractured region was determined using dual energy X-ray absorptiometry. RESULTS AND CONCLUSION: Callus volume in patients with simple femoral shaft fracture was significantly increased at 12 weeks after surgery than at 6 weeks after surgery. But the callus volume in patients with traumatic brain injury complicated by femoral shaft fracture was increased both at 6 and 12 weeks after surgery, and it was larger than that in patients with simple femoral shaft fracture. At 1, 3, 5 weeks after surgery, bone mineral density value was gradually increased in patients with traumatic brain injury complicated by femoral shaft fracture and it was also higher than the corresponding value at the same time point in patients with simple femoral shaft fracture. These results showed that traumatic brain injury can increase the callus volume during healing of femoral shaft fracture, boost the bone mineral density value in the fractured region, and shorten fracture healing time.