中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (22): 4053-4056.doi: 10.3969/j.issn.1673-8225.2012.22.015

• 骨科植入物 orthopedic implant • 上一篇    下一篇

股骨中下段骨折修复后伸膝装置粘连的医源性因素

李  芃1，张朝春2   

  1. 1福建中医药大学骨伤学院，福建省福州市  3501082解放军南京军区福州总医院骨一科，福建省福州市350025
  • 收稿日期:2011-10-14 修回日期:2011-11-12 出版日期:2012-05-27 发布日期:2012-05-27
  • 通讯作者: 张朝春，副教授，硕士生导师，副主任医师，解放军南京军区福州总医院骨科，福建省福州市 350025 zchaochun@163.com
  • 作者简介:李芃，女，1989年生，福建省福州市人，汉族，福建中医药大学在读本科，主要从事中西医临床医学（骨伤科学）方面的研究。 281478168@qq.com

Iatrogenic factors for knee extensor device adhesion after middle and lower femoral fracture repair 

Li Peng1, Zhang Chao-chun2   

  1. 1Department of Orthopedics and Traumatology, Fujian University of Traditional Chinese Medicine, Fuzhou  350108, Fujian Province, China; 2First Department of Orthopedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA, Fuzhou  350025, Fujian Province, China
  • Received:2011-10-14 Revised:2011-11-12 Online:2012-05-27 Published:2012-05-27
  • Contact: Zhang Chao-chun, Associate professor, Master’s supervisor, Associate chief physician, First Department of Orthopedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA, Fuzhou 350025, Fujian Province, China zchaochun@163.com
  • About author:Li Peng, Department of Orthopedics and Traumatology, Fujian University of Traditional Chinese Medicine, Fuzhou 350108, Fujian Province, China 281478168@qq.com

PDF

329

被引次数

11

摘要：

背景：伸膝装置粘连是股骨中下段骨折内固定修复后较为常见的并发症。
目的：探讨影响股骨中下段骨折修复后伸膝装置粘连的医源性因素。
方法：纳入股骨中下段骨折行内固定修复后确诊为伸膝装置粘连的患者90例，分析不同手术入路、内固定方法、治疗后石膏外固定时间、功能锻炼4个因素对伸膝装置粘连发生的影响。
结果与结论：所有病例均获随访，平均随访时间18.7个月。手术入路、内固定方法、功能锻炼、石膏外固定时间是与骨折内固定修复后伸膝装置粘连发生关系密切的医源性因素(P < 0.05)，诸因素与修复后膝关节功能障碍密切相关。股骨中下段骨折的治疗，选择微创髓内钉固定、切开复位钢板内固定选择后外侧入路、修复后减少石膏外固定时间、修复后配合持续被动活动功能锻炼，可显著减少医源性伸膝装置粘连的发生。
 

关键词: 伸膝装置粘连, 股骨中下段骨折, 手术入路, 内固定方法, 术后外固定时间, 功能锻炼

Abstract:

BACKGROUND: Knee extensor device adhesion is one for the common postoperative complications in the femoral lower-middle section fracture.
OBJECTIVE: To investigate the iatrogenic factors for knee extensor device adhesion after the femoral lower-middle section fracture repair.
METHODS: A total of 90 cases that operated on the femoral lower-middle section fracture with internal fixation and diagnosed as knee extensor device adhesion were selected. Effect of different surgical approaches, internal fixation methods, postoperative gesso externally fixation time and postoperative functional exercise on the occurrence of knee extensor device adhesion were statistically analyzed.
RESULTS AND CONCLUSION: All the 90 cases were followed up for an average time of 18.7 months. Surgical approaches, internal fixation methods, postoperative gesso external fixation time and postoperative functional exercise were the iatrogenic factors which had statistically significant correlation with the knee extensor device adhesion (P < 0.05). The treatment of the femoral lower-middle section fracture with open reduction and internal fixation through posterolateral surgical approach, fixed using intramedullary nail, postoperative gesso external fixation time were shortened and the incidence of knee extensor device adhesion can be reduced by using continuous passive motion functional exercise.

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