微创技术取出内固定装置治疗长管状骨骨折愈合患者的临床疗效
Clinical effect of minimally invasive technique of internal fixation device removal in patients with healed long tubular bone fractures.
作者信息
Li Chaoyi, Lin Wei, Wu Guozhi, Zhang Linkang, Zhang Pijun
机构信息
Chaoyi Li, Department of Joint Surgery, The Second Affiliated Hospital of Hainan Medical College, Haikou 570311, Hainan Province, P.R. China.
Wei Lin, Department of Joint Surgery, The Second Affiliated Hospital of Hainan Medical College, Haikou 570311, Hainan Province, P.R. China.
出版信息
Pak J Med Sci. 2023 Jan-Feb;39(1):91-95. doi: 10.12669/pjms.39.1.6967.
OBJECTIVE
To investigate the clinical effect of minimally invasive technique applied to internal fixation removal in patients with healed long tubular bone fractures.
METHODS
The records of patients with internal fixation of long tubular bone fracture who underwent the removal of the internal fixation device after fracture healing in The Second Affiliated Hospital of Hainan Medical College from May 2020 to December 2021 were reviewed. According to the different operation methods of taking out the internal fixation device, patients were divided into minimally invasive group (n=40) and traditional group (n=45). The perioperative indexes, levels of inflammatory factors tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), Karnofsky Performance (KPS), visual analog scale (VAS) pain score and complications were compared between the two groups.
RESULTS
The drainage volume, bleeding volume, incision length and hospital stay in the minimally invasive group were significantly lower than those in the traditional group (0.05). The KPS score of minimally invasive group was significantly higher than that of traditional group at one week and one month after the operation, and the VAS score of minimally invasive group was significantly lower than that of traditional group at one day and one week after the operation (0.05). The levels of TNF-α and CRP in the observation group were significantly lower than those in the control group(<0.05). There was one case of infection in the minimally invasive group, one case of secondary fracture and two cases of infection in the traditional group(>0.05).
CONCLUSIONS
Minimally invasive surgery for the removal of the internal fixation device in patients with healed long tubular bone fractures with internal fixation is associated with significantly improved clinical effect, relieved symptoms, reduced inflammatory response, and improved functional recovery of patients.
目的
探讨微创技术应用于长管状骨骨折愈合患者内固定取出的临床效果。
方法
回顾性分析2020年5月至2021年12月在海南医学院第二附属医院行长管状骨骨折内固定术后骨折愈合而行内固定取出术患者的病历资料。根据取出内固定装置的手术方法不同，将患者分为微创组（n = 40）和传统组（n = 45）。比较两组患者围手术期指标、炎症因子肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）水平、卡氏功能状态评分（KPS）、视觉模拟评分法（VAS）疼痛评分及并发症情况。
结果
微创组的引流量、出血量、切口长度及住院时间均明显低于传统组（P<0.05）。微创组术后1周和1个月时的KPS评分明显高于传统组，术后1天和1周时的VAS评分明显低于传统组（P<0.05）。观察组TNF-α和CRP水平明显低于对照组（P<0.05）。微创组有1例感染，传统组有1例二次骨折和2例感染（P>0.05）。
结论
微创技术用于长管状骨骨折愈合且有内固定患者的内固定取出术，临床效果显著改善，症状缓解，炎症反应减轻，患者功能恢复良好。
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