记忆合金内接骨板和可吸收肋骨钉在治疗多发性肋骨骨折中的临床应用

目的探讨记忆合金环抱接骨板和可吸收肋骨钉在治疗多发性肋骨骨折的临床疗效。方法选取我院胸外科收治的36例多发性肋骨骨折患者,按照随机的原则选取其中20例患者(记忆合金组),应用记忆合金接骨板将肋骨骨折部位切开复位。选取采用可吸收肋骨钉内固定的16例患者作为对照组(肋骨钉组)。比较手术时间,住院费用及术后两组患者的胸痛缓解时间、住院时间、骨折愈合状况及相关并发症发生情况。结果两组患者均临床愈合.治愈率均为100%。但肋骨钉组出现2例骨折断端偏移,畸形愈合;而记忆合金组未出现骨折断端移位情况。两组平均手术时间及住院费用无明显差异(P>0.05)。两组患者的胸痛缓解时间、住院时间、胸壁畸形、骨折愈合状况及相关并发症发生率无明显差异(P>0.05)。结论应用记忆合金内接骨板及可吸收肋骨钉均有利于促进骨折愈合,有助于呼吸功能改善.是治疗多发性肋骨骨折较理想的方法。但对于骨折内径偏小,斜行骨折断端大于3cm,粉碎性骨折应避免使用可吸收肋骨钉。防治术后骨折端移位。对不同类型的骨折应选用其适合的内固定方法。

Comparison of Memory Alloy Internal Bone Bonding Plate and Absorbable Rib Nail in Treatment of Multiple Rib Fracture Cases

Objective Curative effects of memory alloy encircling bone bonding plates and that of absorbable rib nails in multiple rib fracture cases are to be discussed and compared in this paper. Methods 20 of the 36 cases of multiple rib fracture admitted in the Thoracic Surgery Department of Sichuan Province No. 4 Hospital from January 2008 to Janu- ary 2013 were chosen randomly to be operated by cutting rib fracture parts and restoring the fracture parts with memory alloy bone bonding plates; The rest 16 patients who were operated with absorbable rib nails are divided as the control group. These two groups are compared in terms of operation duration time, hospital charges and the following-up obser- vations, such as relief of chest pain, hospital stay, fracture healing and the related complications. Results The fracture sites of both groups of patients have been successfully closed up with clinical treatment. Cure rates of both groups are 100%. However, the rib nail group occurred 2 cases of displacement of fracture site and malformation healing; while the memory alloy group had no such displacement case. These two groups have no distinctive differences in terms of average operation duration time and hospital charges （P〉0. 05）. Further, these two groups have no obvious differences in terms of duration time of chest pain relief, hospital stay, malformation of chest wall, fractured healing and the incidence rate of the related complications （atelectasis, pulmonary infection） （P〉0.05）. Conclusion Both treatments, namely, the treatment with memory alloy internal bone bonding plate and the treatment with absorbable rib nail, will facilitate fracture healing and improve breathing function of patients, and both treatments are relatively ideal for multiple rib fracture cases. However, absorbable rib nails are not an ideal option for the fracture case with a relatively small inner diameter of frac- ture site, an oblique fracture site which exceeds 3 cm and is not ideal for comminuted fracture. Such suggestion is pro- posed to prevent fracture displacement after operation. Internal bone bonding treatments shall vary from different types of fracture cases.