多发肋骨骨折手术治疗75例临床分析

目的探讨多发肋骨骨折急救中保留肋骨骨膜爪形肋骨同定板内同定手术的疗效和应用价值。方法本实验自2006年7月～2012年3月开展保留肋骨骨膜爪形肋骨同定板治疗多发肋骨骨折所致连枷胸75例，与2003年3月～2006年6月多根多处肋骨骨折肋骨同定带外同定病例47例对照比较。结果内阿定组治愈75例，平均下床自主活动时间为术后5d，平均住院时间为12d。出院后均无明显胸廓畸形及术侧胸部、肩部、上肢疼痛及活动障碍等后遗症。术后2～3个月复查胸片，骨折基本骨性愈合，同时，术后发生呼吸衰竭、血气胸、肺不张及肺部感染等并发症较非内同定手术治疗的肋骨固定带组47例有明显减少，差异有统计学意义（P〈0．05）。结论钛金属爪形肋骨同定板保留肋骨骨膜肋骨内固定治疗多发肋骨骨折较非手术治疗的肋骨同定带具有更好的疗效。

Clinical analysis of 75 cases of multiple rib fractures undergoing surgical treatment

Objective To explore the efficacy and value of the internal fixation with claw-like nb fixed plates preserving the periosteum for the emergency treatment of multiple rib fractures. Methods 75 cases of multiple fractured ribs flail chest in this experiment from July 2006 to March 2012 with the treatment of frame membrane claw frame fixed plate were com- pared with 47 patients with the treatment root ribs fracture frame band external fixed from March 2003 to June 2006. Re- suits All of 75 patients undergoing internal fixation were cured, the average ambulation time was 5 days postoperatively and the median length of hospital stay was 12 days. No complications occurred such as significant thoracic deformity, movement disorder and pain of chest, shoulder and upper limb on the operative side. Chest X-ray 2-3 months postopera- tively showed the bony healing of fractures. Compared to the non-in internal fixation group, the rate of complications in cluding respiratory failure, hemopneumothorax, atelectasis and pneumonia significantly decreased （P 〈 0.05）. Conclusion The internal fixation with claw-like titanium rib fixed plates preserving the periosteum has better efficacy than other non- operative routine therapy.