[1]王金良,徐行,张黎.制槽法取出滑丝螺钉的疗效研究[J].中华老年骨科与康复电子杂志,2019,(06):342-347.[doi:10.3877/cma.j.issn.2096-0263.2019.06.008]
 Wang Jinliang,Xu Hang,Zhang Li.Study on the effect of removing the slide wire screw by the grooved method[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2019,(06):342-347.[doi:10.3877/cma.j.issn.2096-0263.2019.06.008]
点击复制

制槽法取出滑丝螺钉的疗效研究()
分享到:

中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2019年06期
页码:
342-347
栏目:
临床论著
出版日期:
2019-12-05

文章信息/Info

Title:
Study on the effect of removing the slide wire screw by the grooved method
作者:
王金良徐行张黎
050051 石家庄,河北医科大学第三医院骨科
Author(s):
Wang Jinliang Xu Hang Zhang Li
Department of Orthopedics, the Third Hospital of Hebei Medical University, Shijiazhuang 050051, China
关键词:
骨折固定术 骨螺钉 滑丝
Keywords:
Fracture fixation internal Bone screws Sliding wire
DOI:
10.3877/cma.j.issn.2096-0263.2019.06.008
文献标志码:
A
摘要:
目的 对比制槽法与传统方法取出滑丝螺钉的临床疗效,探讨一种取出滑丝螺钉的新方法。方法 前瞻性收集河北医科大学第三医院2012年9月至2017年1月,收治的内固定取出患者1 552例,其中符合纳入及排除标准的患者共132例,通过随机数字表随机分为试验组(n=66)和对照组(n=66)。试验组采用制槽法,对照组采用传统方法,从手术成功率、平均手术时间、平均术中出血量及平均切口愈合时间四个方面,进行试验组及对照组的对照研究分析。结果 本研究所纳入的132例患者均未出现神经血管损伤、术后再骨折等并发症。试验组手术成功率(98.61%)和对照组手术成功率(98.59%)差异无统计学意义(c2=0.001,P=0.992),试验组的平均手术时间为(32±6)min、平均术中出血量为(154±37)ml、平均切口愈合时间为(11.8±1.1)d,均少于对照组,差异有统计学意义(U=143,t=6.463,U=1438,P<0.05)。结论 制槽法减少了手术操作步骤从而缩短了手术时间,不会产生骨质及软组织的进一步损伤,从而减少了术中出血量及切口愈合时间,适用于单个或多个螺钉滑丝的情况,为临床上解决滑丝螺钉的问题提供了一种简单实用、安全有效的新方法。
Abstract:
Objective To compare the clinical efficacy of the slide wire screw with the grooved method and the traditional methods, and to explore a new method to remove the slide wire screw. Methods A prospective collection of 1 552 patients with internal fixations from September 2003 to January 2017 in the third hospital of Hebei Medical University was conducted. Among them, 132 patients who met the inclusion and exclusion criteria were randomly divided into experimental group (n=66) and controlled group (n=66) by random number table. The experimental group used the grooved method, and the controlled group used the traditional methods. The experimental group and the controlled group were compared and analyzed from four aspects: the successful rate of surgery, the average operational time, the average intraoperative blood loss and the average incision healing time. Results All 132 patients included in the study had no complications such as neurovascular injury and postoperative fracture. There was no significant difference in the successful rate (98.61%) between the experimental group and the success rate (98.59%) in the controlled group. The mean operative time [(32±6) min], mean intraoperative blood loss [(154±37) ml], and mean incision healing time [(11.8±1.1) d] were lower in the experimental group than in the controlled group, the difference was statistically significant (U=143, t=6.463, U=1438, P<0.05). Conclusions The grooved method reduces the surgical procedure and shortens the operational time. It does not cause further damage to the bone and soft tissue, thus reducing the amount of intraoperative blood loss and wound healing time. It is suitable for single or multiple sliding screws. It provides a simple, practical, safe and effective new method for solving the problem of the sliding screws.

参考文献/References:

1 肖雄. 骨凿撬动方法在螺钉滑牙锁定钢板取出中的应用 [J]. 中国矫形外科杂志, 2019, 27(10): 930-933.
2 吴佳俊, 朱越. 锁定加压钢板及锁定螺钉取出困难相关因素分析 [J]. 中华临床医师杂志:电子版, 2013, 7(24): 11858-11860.
3 肖文庆. 骨折内固定物取出困难15例原因分析及对策 [J]. 中国中医骨伤科杂志, 2013, 21(4): 55-56.
4 李晨. 滑丝螺钉取出困难相关因素分析及处理比较 [J]. 中国现代医生, 2016, 54(8): 69-71.
5 Barcak EA, Weinlein JC. The role of implant removal in orthopedic trauma [J]. Orthop Clin North Am, 2018, 49(1): 45-53.
6 万永鲜. 骨科内固定物取出困难的常见原因及应对策略 [J]. 中国骨与关节损伤杂志, 2016, 31(11): 1229-1230.
7 陈芝印. 锁定板钻孔在骨折术后冷焊接螺钉取出术中的应用 [J]. 中国骨与关节损伤杂志, 2017, 32(5): 553-554.
8 刘振东, 马梦然. 内固定物是否应该取出 [J]. 中国矫形外科杂志, 2007 (12): 958-959.
9 Naumann MG, Sigurdsen U, Utvag SE, et al. Incidence and risk factors for removal of an internal fixation following surgery for ankle fracture: A retrospective cohort study of 997 patients [J]. Injury- International Journal of the Care of the Injured, 2016, 47(8): 1783-1788.
10 Garner MR, Thacher RR, Ni AM, et al. Elective removal of implants after open reduction and internal fixation of Tibial Plateau fractures improves clinical outcomes [J]. Arch Orthop Trauma Surg, 2015, 135(11): 1491-1496.
11 Williams BR, Mccreary DL, Chau MA, et al. Functional outcomes of symptomatic implant removal following ankle fracture open reduction and internal fixation [J]. Foot Ankle Int, 2018, 39(6): 674-680.
12 孙宁. 四肢骨折术后内固定螺钉取出困难的危险因素分析 [J]. 北京大学学报(医学版), 2016,48(2): 373-376.
13 王华溢. 锁定螺钉取出困难的原因分析及解决方案 [J]. 中国骨与关节损伤杂志, 2013, 28(3): 292-293.
14 Gopinathan NR, Dhillon MS, Kumar R, et al. Simple Technique for Removing a Locking Recon Plate With Damaged Screw Heads [J]. Clin Orthop Relat Res, 2013,471(5): 1572–1575.
15 Gupta R. Hollow mill for extraction of stripped Titanium screws: an easy, quick, and safe technique [J]. J Surg Tech Case Rep, 2014, 6(1): 9-11.
16 Kim, SJ. A Simple Technique for Removing a Locking Compression Plate With a Stripped Locking Screw [J]. Orthop Trauma, 2012, 26(6): 51-53.
17 Zhao, Y. Hardware removal or preservation?Decision making based on a newly developed rating scale [J]. Injury, 2018, 49(11): 1999-2004.

相似文献/References:

[1]沈鹏程 朱立帆 蒋富贵 鞠文 徐能 李晓林.锁定钢板结合重建肱骨内侧柱治疗老年不稳定型肱骨近端骨折的疗效分析[J].中华老年骨科与康复电子杂志,2015,(02):7.[doi:10.3877/cma.j.issn.2096-0263.2015.02.002]
 Shen Pengcheng,Zhu Lifan,Jiang Fugui,et al.Clinical research of locking plate combined with medial column mechanical support for unstable fractures of the proximal humerus in elderly patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2015,(06):7.[doi:10.3877/cma.j.issn.2096-0263.2015.02.002]
[2]李梦远,陈宏 马元琛,廖俊星,等.老年髋部骨折内固定失败后补救性髋关节置换术的临床研究[J].中华老年骨科与康复电子杂志,2016,(02):81.[doi:10.3877/cma.j.issn.2096-0263.2016.02.004]
 Li Mengyuan,Chen Hong,Ma Yuanchen,et al.Clinical research of hip arthroplasty as a salvage treatment after reduction and fixation failure in the proximal femoral fracture[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(06):81.[doi:10.3877/cma.j.issn.2096-0263.2016.02.004]
[3]黄晓文,公茂琪,查晔军,等.早期快速闭合复位空心钉内固定治疗高龄股骨颈骨折的临床研究[J].中华老年骨科与康复电子杂志,2017,(01):4.[doi:10.3877/cma.j.issn.2096-0263.2017.01.002]
 Huang Xiaowen,Gong Maoqi,Zha Yejun,et al.Clinical results of early and rapid close reduction with internal fixation cannulated screws for femoral neck fractures in elderly patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(06):4.[doi:10.3877/cma.j.issn.2096-0263.2017.01.002]
[4]黄鑫,苏柯,王晓宁,等.围手术期内科并存病对高龄股骨转子间骨折术后疗效的影响[J].中华老年骨科与康复电子杂志,2017,(01):11.[doi:10.3877/cma.j.issn.2096-0263.2017.01.003]
 Huang xin,Su Ke,Wang Xiaoning,et al.Influence of preoperative complications on the clinical outcome of elderly intertrochanteric fractures patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(06):11.[doi:10.3877/cma.j.issn.2096-0263.2017.01.003]
[5]陈佳,李西成.髋部骨折:争议与挑战[J].中华老年骨科与康复电子杂志,2017,(04):193.[doi:10.3877/cma.j.issn.2096-0263.2017.04.001]
 Chen Jia,Li Xicheng.Hip fracture: Controversy and challenge[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(06):193.[doi:10.3877/cma.j.issn.2096-0263.2017.04.001]
[6]卢冰,王跃,刘攀,等.髓内钉及动力髋螺钉治疗老年稳定性股骨转子间骨折的比较[J].中华老年骨科与康复电子杂志,2017,(05):260.[doi:10.3877/cma.j.issn.2096-0263.2017.05.002]
 Lu Bing,Wang Yue,Liu Pan,et al.Comparison of the clinical efficacy between proximal femoral nail and DHS in the treatment of elderly patients with intertrochanteric fractures[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(06):260.[doi:10.3877/cma.j.issn.2096-0263.2017.05.002]
[7]覃宇宙,蔡贤华,林开胜.PFNA治疗90岁以上高龄股骨转子间骨折的临床疗效[J].中华老年骨科与康复电子杂志,2017,(05):281.[doi:10.3877/cma.j.issn.2096-0263.2017.05.006]
 Qin Yuzhou,Cai Xianhua,Lin Kaisheng.Clinical effectiveness of PFNA for treatment of nonagenarian intertrochanteric fractures[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(06):281.[doi:10.3877/cma.j.issn.2096-0263.2017.05.006]
[8]李祖涛,缪晓刚,周文正,等.钢板系统治疗髓内固定失败的股骨无菌性骨不连疗效观察[J].中华老年骨科与康复电子杂志,2018,(04):198.[doi:10.3877/cma.j.issn.2096-0263.2018.04.002]
 Li Zutao,Miao Xiaogang,Zhou Wenzheng,et al.Treatment of femur aseptic non-unions after intramedullary nailing interfixation with locking plate[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(06):198.[doi:10.3877/cma.j.issn.2096-0263.2018.04.002]
[9]鲍飞龙 刘涛 亢世杰 黄东生 江涛 胡义明. 双反牵引装置治疗Schatzker分型Ⅴ、Ⅵ型胫骨平台骨折的优势[J].中华老年骨科与康复电子杂志,2018,(05):266.
 Bao Feilong,Liu Tao,Kang Shijie,et al.The advantage of homeopathic double reverse traction device treating tibial plateau fractures of typing Schatzker Ⅴ and Ⅵ[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(06):266.
[10]孙再杰,杨思宇,汪国栋,等.动力化治疗下肢长骨骨折术后延迟愈合的研究进展[J].中华老年骨科与康复电子杂志,2019,(02):118.[doi:10.3877/cma.j.issn.2096-0263.2019.02.011]
 Sun Zaijie,Yang Siyu,Wang Guodong,et al.Progress in the research on delayed union after long bone fracture of lower limb treated by dynamization[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2019,(06):118.[doi:10.3877/cma.j.issn.2096-0263.2019.02.011]
[11]赵晨,商培洋,车凌宾,等.锁定钢板治疗老年肱骨近端骨折合并肩袖撕裂的疗效分析[J].中华老年骨科与康复电子杂志,2015,(01):22.
[12]王沈栋,佘昶,董启榕.闭合复位空心螺钉治疗股骨颈骨折后股骨头坏死的影响因素分析[J].中华老年骨科与康复电子杂志,2019,(05):284.[doi:10.3877/cma.j.issn.2096-0263.2019.05.008]
 Wang Shendong,She Chang,Dong Qirong.Analysis of influencing factors related to femoral head necrosis after closed reduction and internal fixation with hollow screws[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2019,(06):284.[doi:10.3877/cma.j.issn.2096-0263.2019.05.008]

备注/Memo

备注/Memo:
基金项目:河北省中医药管理局科研计划资助项目(2017183)
更新日期/Last Update: 2019-12-11