拉力螺钉辅助交锁髓内钉治疗股骨干复杂骨折对骨痂含量的影响

背景:生物力学研究及临床病例观察发现,用交锁髓内钉治疗股骨干复杂骨折,使用拉力螺钉辅助固定粉碎骨折块,能优化骨折的力学传导,促进骨折愈合。目的:观察交锁髓内钉内固定治疗股骨干复杂骨折中,用拉力螺钉固定粉碎性骨折块对骨折愈合的意义。方法:交锁髓内钉内固定治疗的股骨干病例60例,分为拉力钉组、旷置组;随机选取两组患者内固定后第1周、第12周的数字X射线摄正位片,测定骨痂区、正常骨区及正常软组织区的灰度密度,骨痂区自身对照灰度率,进行组内、组间对比分析。结果与结论:正常骨区及正常软组织区的灰度密度比较,差异无显著性意义。骨痂区域灰度密度值,两组内固定后第12周显著高于第1周(P<0.01);内固定后第12周组拉力钉组显著高于旷置组(P<0.01)。拉力钉组自身对照灰度率显著高于旷置组(P<0.01)。提示用拉力螺钉辅助固定粉碎性骨折块后,有助于骨痂形成,骨痂含量大于旷置骨折块者。

Effect of lag screw auxiliary interlocking intramedullary nail for complicated fracture of femoral shaft on callus content

BACKGROUND: Biomechanical studies and clinical cases observation discovers that using interlocking intramedullary nail for the treatment of complicated fracture of femoral shaft and using lag screw assisted fixation of comminuted fracture piece, can optimize fracture conductivity and promote fracture healing. OBJECTIVE: To explore the effect of lag screws fixation for comminuted fractures of block fixation on the significance of fracture healing during interlocking intramedullary nail fixation for the treatment of complicated fracture of femoral shaft in operation. METHODS: Totally 60 cases with interlocking intramedullary nail internal fixation for the treatment of femoral shaft were divided into pulling nail group and exclusion group. Digital X-ray posteroanterior films at 1 and 12 weeks after internal fixation in each group were randomly selected. Gray-scale density of callus area, normal bone area and normal soft tissue area was detected. Comparative analysis of callus area self control gray rate in intragroup and intergroup. RESULTS AND CONCLUSION: There was no significant difference of the gray-scale density in the normal bone area and normal soft tissue area (P < 0.01), but gray-scale density at 12 weeks after internal fixation was higher than that at 1 week after internal fixation in callus area (P < 0.01). At 12 weeks after internal fixation, gray-scale density of the pulling nail group was obviously higher than that of the exclusion group (P < 0.01). Self control gray rate of the pulling nail group was obviously higher than that of the exclusion group (P < 0.01). The lag screw fixation for comminuted fractures after auxiliary block can contribute to the formation of callus, and bone callus content in the pulling nail group is higher than that in the exclusion group.