不同内固定下肱骨干骨折愈合的前瞻性影像学研究

目的从影像学角度对天鹅记忆接骨器(SMC)、动力加压钢板(DCP),交锁髓内钉(LIN)治疗肱骨干骨折的疗效进行前瞻性对比研究。方法肱骨干骨折患者125例分别接受上述3种内固定治疗,定期进行X线检查,观察骨折愈合情况,取出内固定后进行CT扫描。结果DCP组骨痂出现较晚、量较少,骨折线消失最晚,骨折区域灰度密度积分及CT值较低;LIN组骨痂出现最早、量较多,骨折线消失较晚,骨折区灰度密度积分较高,骨折区域CT值较低;SMC组基本无骨痂出现,骨折线消失最早,并由板状骨直接替代,骨折区域灰度密度积分及CT值较高。结论与DCP和LIN相比,SMC具有力学性能和几何构型上的优势,在促进骨折愈合的速度、方式及质量上有明显的优越性。

A radiographic prospective study on different internal fixation for healing fractures of shaft of humerus

Aim To prospectively compare the radiographic effects of Swan like memory connector (SMC),versus dynamic compression plate (DCP) and locked intramedullary nail (LIN) in treating fractures of shaft of humerus.Methods 125 patients with humerus fracture accepted three kinds of internal fixations respectively, including SMC, DCP and LIN. All patients underwent X ray termly to observe the healing condition of fractures. After internal fixation removal, patients underwent CT scan to observe the healing condition.Results The callus formation in the LIN group was found earlier than that in the DCP group. The callus amount of the DCP groups was less than that of the LIN group. Neither callus nor osteoporosis was found in the SMC group. The fracture line vanished fastest in SMC group and slowest in the DCP group. The bone gray degree density(BGD)and CT value in the SMC group were higher than those in the DCP and LIN group.Conclusion Compared with LIN and DCP, SMC has an advantage in mechanics behavior and geometrical configuration, especially in improving the speed, form and quality of the fracture healing.