可吸收肋骨固定钉加涤纶补片治疗多发性肋骨骨折12例

目的：介绍加用涤纶补片外包裹固定治疗多发性肋骨骨折的方法及适应证,以减少骨折移位并发症的发生。方法：自2006年9月至2008年3月采用可吸收肋骨钉加涤纶补片治疗多发性肋骨骨折12例,男8例,女4例;年龄22～51岁,平均38.2岁;受伤至手术时间：2h～3d。均为闭合性损伤且伴有明显胸痛及胸闷气闭,其中伴呼吸困难、咳痰中带血、血氧饱合度下降4例。X线检查：单侧肋骨骨折3例,双侧肋骨骨折9例,均伴有血气胸。结果：12例患者均获得随访,时间2～26个月,平均8个月。所有病例骨折均愈合。依据评定标准,从疼痛、呼吸、肋骨对位情况等方面对疗效进行观察：优10例,良1例,可1例。结论：应用可吸收肋骨钉加涤纶补片治疗多发性肋骨骨折是安全有效的,特别适用于骨质疏松、粉碎性骨折及斜形骨折的患者。

Treatment of fracture of multiple ribs with absorbable rib fixed nail and dacron flap in 12 patients

Objective: To introduce the methods of dacron flap application and its indications in treating fracture of multiple ribs,in order to reduce the incidence of the complications of fracture displacement. Methods: From September 2006 to March 2008,12 patients with fracture of multiple ribs were treated with absorbable rib fixed nail and dacron flap. Included 8 males and 4 females,the age was from 22 to 51 years with an average of 38.2 years,the operative time was 2 hours to 3 days after injured. All the patients were closed injury and simultaneously accompanied with significant chest pain and chest tightness. 4 cases with dyspnea,blood in sputum and blood oxygen saturation decreased. The X-ray showed 3 cases of unilateral fracture and 9 cases of bilateral rib fractures and all cases accompanied with hemopneumothorax. Results: All patients were followed up from 2 to 26 months with an average of 8 months. All the fractures healed. According to clinical criteria,pain,breathing, ribs alignment etc. to observe the effect,10 cases got excellent result,1 case good,1 case poor. Conclusion: It is safe and effective to use absorbable rib fixed nails and dacron flap for treating fracture of multiple ribs and especially for the patients of osteoporosis,comminuted fracture or oblique fracture.