Two Internal Fixation Methods for Multiple Rib Fractures: A Case Control Study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

赵天成 , 杨异 , 高宗礼 , 何伟伟 , 吴伟铭

上海市第六人民医院胸外科（上海 200233）;

Corresponding author：

Keywords：

多发性肋骨骨折; 内固定; 可吸收肋骨钉; 记忆合金接骨板

DOI：

10.7507/1007-4848.20150178

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目的探讨可吸收肋骨钉与记忆合金接骨板内固定两种方法治疗多发性肋骨骨折的效果。方法回顾性分析2009年1月至2014年1月在上海市第六人民医院胸外科行手术内固定的胸部外伤致多根多处肋骨骨折患者321例的临床资料，其中可吸收肋骨钉组70例，其中男62例、女8例，年龄（48.54±9.74）岁；记忆合金接骨板组251例，其中男187例、女64例，年龄（51.44±10.22）岁。分析两组患者疗效差异。结果两组患者术前疼痛评分（7.74±0.89 vs.7.66±0.92）、术后疼痛评分（3.80±0.79 vs.3.82±0.85），术后胸腔引流时间[（6.00±2.84）d vs.（5.68±2.98）d]差异均无统计学意义（P>0.05）。记忆合金接骨板组住院时间[（20.06±7.39）d vs.（17.77±7.68）d]，及手术时间（101.29±30.67）min vs.（71.95±29.50）min]均短于可吸收肋骨钉组，且差异有统计学意义（P＜0.05)。术后3个月随访复查胸部X线，两组患者骨折再移位差异无统计学意义。结论可吸收肋骨钉与记忆合金接骨板均是治疗多发性肋骨骨折较理想的术式，记忆合金接骨板手术操作更为简单，可吸收肋骨钉手术无需在体内留置金属内固定装置，但固定强度较接骨板略差，应根据情况选择合适的内固定方法。

Citation： 赵天成, 杨异, 高宗礼, 何伟伟, 吴伟铭. Two Internal Fixation Methods for Multiple Rib Fractures: A Case Control Study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(7): 704-706. doi: 10.7507/1007-4848.20150178 Copy

1.	Richardson JD, Franklin GA, Hefley S, et al. Operative fixation of chest wall fractures:an underused procedure? Am Surg, 2007, 73(6):591-597.
2.	Maxwell CA, Mion LC, Dietrich MS, et al. Hospitalized injured older adults:clinical utility of a rib fracture scoring system. J Trauma Nurs, 2012, 19(3):168-174.
3.	Vyhnanek F, Skrla P, Skrabalov D. A contribution of multi detector computed tomography to indications for chest wall stabilisation in multiple rib fractures. Acta Chir Orhop Traumatol Cech, 2011, 78(3):258-261.
4.	Mayberry JC, Ham LB, Schipper PH, et al. Surveyed opinion of American trauma,orthopedic,and thoracic surgeons on rib and sternal fracture repair. J Trauma, 2009, 66(3):875-879.
5.	Kerr-Valentic MA, Arthur M, Mullins RJ, et al. Rib fracture pain and disability:can we do better. J Trauma, 2003, 54(6):1058-1063.
6.	Skowronek P, Dutka J, Skowronek M, et al. Treatment of open femur fracture with critical bone loss of femoral shaft in politrauma patient-case report. Chir Narzadow Ruchu Ortop Pol, 2011, 76(5):291-294.
7.	Balci AE, Eren S, Cakir O, et al. Open fixation in flail chest:review of 64 patients. Asian Cardiovasc Thorac Ann, 2004, 12 (1):11-15.
8.	Nirula R, Diaz JJ Jr, TrunkeyDD, et al. Rib fracture repair:indications, technical issues, and future directions. World J Surg, 2009, 33 (1):14-22.
9.	徐志飞, 孙居仙. 肋骨骨折的诊疗进展. 中华创伤杂志, 2010, 26(6):481-482.
10.	陈文, 杨正府. 早期内固定治疗多发性肋骨骨折40例. 创伤外科杂志, 2011, 13(4):356-358.
11.	杨异, 何伟伟, 高宗礼, 等. 可吸收肋骨钉治疗多发肋骨骨折. 中华胸心血管外科杂志, 2011, 27(7):439-440.
12.	谢骏, 栗兰凯, 魏小东, 等. 应用镍钛合金环抱器治疗多发性肋骨骨折67例. 创伤外科杂志, 2006, 8(3):265.
13.	袁涛, 马彪, 米学伟, 等. DR与多层螺旋CT三维重建技术在肋骨骨折诊断中的对比应用. 解放军医药杂志, 2013, 25(8):64-66.
14.	黄铿, 谢扬, 徐玉玲, 等. 非手术治疗连枷胸69例的治疗指征和疗效分析. 现代医院, 2013, 13(8):50-51.
15.	黄永祥, 吕青青, 曹朝梁, 等. 可吸收肋骨钉与记忆合金接骨板内固定治疗多发性肋骨骨折的效果比较. 中国医药导报, 2014, 11:47-50.

1. Richardson JD, Franklin GA, Hefley S, et al. Operative fixation of chest wall fractures:an underused procedure? Am Surg, 2007, 73(6):591-597.
2. Maxwell CA, Mion LC, Dietrich MS, et al. Hospitalized injured older adults:clinical utility of a rib fracture scoring system. J Trauma Nurs, 2012, 19(3):168-174.
3. Vyhnanek F, Skrla P, Skrabalov D. A contribution of multi detector computed tomography to indications for chest wall stabilisation in multiple rib fractures. Acta Chir Orhop Traumatol Cech, 2011, 78(3):258-261.
4. Mayberry JC, Ham LB, Schipper PH, et al. Surveyed opinion of American trauma,orthopedic,and thoracic surgeons on rib and sternal fracture repair. J Trauma, 2009, 66(3):875-879.
5. Kerr-Valentic MA, Arthur M, Mullins RJ, et al. Rib fracture pain and disability:can we do better. J Trauma, 2003, 54(6):1058-1063.
6. Skowronek P, Dutka J, Skowronek M, et al. Treatment of open femur fracture with critical bone loss of femoral shaft in politrauma patient-case report. Chir Narzadow Ruchu Ortop Pol, 2011, 76(5):291-294.
7. Balci AE, Eren S, Cakir O, et al. Open fixation in flail chest:review of 64 patients. Asian Cardiovasc Thorac Ann, 2004, 12 (1):11-15.
8. Nirula R, Diaz JJ Jr, TrunkeyDD, et al. Rib fracture repair:indications, technical issues, and future directions. World J Surg, 2009, 33 (1):14-22.
9. 徐志飞, 孙居仙. 肋骨骨折的诊疗进展. 中华创伤杂志, 2010, 26(6):481-482.
10. 陈文, 杨正府. 早期内固定治疗多发性肋骨骨折40例. 创伤外科杂志, 2011, 13(4):356-358.
11. 杨异, 何伟伟, 高宗礼, 等. 可吸收肋骨钉治疗多发肋骨骨折. 中华胸心血管外科杂志, 2011, 27(7):439-440.
12. 谢骏, 栗兰凯, 魏小东, 等. 应用镍钛合金环抱器治疗多发性肋骨骨折67例. 创伤外科杂志, 2006, 8(3):265.
13. 袁涛, 马彪, 米学伟, 等. DR与多层螺旋CT三维重建技术在肋骨骨折诊断中的对比应用. 解放军医药杂志, 2013, 25(8):64-66.
14. 黄铿, 谢扬, 徐玉玲, 等. 非手术治疗连枷胸69例的治疗指征和疗效分析. 现代医院, 2013, 13(8):50-51.
15. 黄永祥, 吕青青, 曹朝梁, 等. 可吸收肋骨钉与记忆合金接骨板内固定治疗多发性肋骨骨折的效果比较. 中国医药导报, 2014, 11:47-50.

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