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[1]倪前偉,戴禹潤,金立昆,等.踝關(guān)節(jié)3.5mm全螺紋空心無頭加壓螺釘取出困難原因分析[J].中醫(yī)正骨,2021,33(02):17-19.
　NI Qianwei,DAI Yurun,JIN Likun,et al.Cause analysis of difficulty in removal of 3.5-mm diameter full-thread hollow headless compression screws used for treatment of ankle fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(02):17-19.
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踝關(guān)節(jié)3.5mm全螺紋空心無頭加壓螺釘取出困難原因分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期數(shù):
2021年02期
頁碼:
17-19
欄目:
臨床研究
出版日期:
2021-02-20

文章信息/Info

Title:
Cause analysis of difficulty in removal of 3.5-mm diameter full-thread hollow headless compression screws used for treatment of ankle fractures
作者:
倪前偉; 戴禹潤; 金立昆; 李曄; 張杰; 董延旭
(北京市豐盛中醫(yī)骨傷專科醫(yī)院,北京 100034)
Author(s):
NI Qianwei; DAI Yurun; JIN Likun; LI Ye; ZHANG Jie; DONG Yanxu
Beijing Fengsheng Special Hospital of Traditional Medical Traumatology and Orthopaedics,Beijing 100033,China
關(guān)鍵詞:
踝關(guān)節(jié);  骨釘;  骨折固定術(shù); 內(nèi);  手術(shù)中并發(fā)癥
Keywords:
ankle joint;  bone nails;  fracture fixation; internal;  intraoperative complications
摘要:
目的:探討踝關(guān)節(jié)3.5 mm全螺紋空心無頭加壓螺釘取出困難的原因。方法:選取2019年4—12月行踝關(guān)節(jié)內(nèi)固定(包括3.5 mm全螺紋空心無頭加壓螺釘)取出術(shù)患者的病例資料進(jìn)行分析。統(tǒng)計(jì)患者的人數(shù)、性別、年齡,及使用3.5 mm全螺紋空心無頭加壓螺釘?shù)臄?shù)量、材料、使用部位、留置時(shí)間。按照是否發(fā)生螺釘取出困難,將患者分為螺釘正常取出組和螺釘取出困難組,對(duì)螺釘取出困難的原因進(jìn)行統(tǒng)計(jì)分析。結(jié)果:符合要求的患者共31例,涉及87枚3.5 mm全螺紋空心無頭加壓螺釘,均為國內(nèi)同一廠家生產(chǎn)的TC4鈦合金螺釘。螺釘正常取出組26例(77枚螺釘),螺釘取出困難組5例(10枚螺釘),螺釘取出困難發(fā)生率為11.49%。螺釘正常取出組男13例、女13例,螺釘取出困難組男2例、女3例; 2組患者的性別比較,差異無統(tǒng)計(jì)學(xué)意義(χ2=0.000,P=1.000)。2組患者年齡比較,差異無統(tǒng)計(jì)學(xué)意義[(49.80±11.72)歲,(43.60±12.09)歲,t=1.044,P=0.305]。螺釘取出困難組患者的螺釘留置時(shí)間比螺釘正常取出組長[(14.78±3.08)個(gè)月,(16.10±1.14)個(gè)月,t=2.550,P=0.016]。螺釘正常取出組螺釘應(yīng)用于外踝33枚、內(nèi)踝39枚、后踝5枚,螺釘取出困難組螺釘應(yīng)用于外踝1枚、內(nèi)踝4枚、后踝5枚; 2組患者的螺釘應(yīng)用部位比較,差異有統(tǒng)計(jì)學(xué)意義(P=0.001); 螺釘取出困難組中螺釘應(yīng)用于后踝(50%)和內(nèi)踝(9.3%)的比例更高。結(jié)論:踝關(guān)節(jié)骨折應(yīng)用3.5 mm全螺紋空心無頭加壓螺釘固定,后期發(fā)生螺釘取出困難的風(fēng)險(xiǎn)較高; 螺釘留置時(shí)間過長及固定后踝或內(nèi)踝骨折更易發(fā)生螺釘取出困難。
Abstract:
To explore the causes of difficulty in removal of 3.5-mm diameter full-thread hollow headless compression screws(HCSs)used for treatment of ankle fractures.Methods:The medical records of patients who received ankle internal fixation removal surgery from April 2019 to December 2019 were selected out.In the surgery,the 3.5-mm diameter full-thread hollow HCSs were used.The information,including quantity,gender,age of patients and quantity,material,location,indwelling time of 3.5-mm diameter full-thread hollow HCSs,were extracted from the medical records and were analyzed.The patients were divided into normal removal group and difficult removal group according to whether the screws were difficult to remove,and the causes of difficulty in screw removal were statistically analyzed.Results:Thirty-one patients(87 3.5-mm diameter full-thread hollow TC4 titanium alloy HCSs produced by the same domestic manufacturer)were enrolled in the study,26 cases(77 screws)in normal removal group and 5 cases(10 screws)in difficult removal group.The incidence rate of difficulty in screw removal was 11.49%.The patients consisted of 13 males and 13 females in normal removal group and the patients consisted of 2 males and 3 females in difficult removal group.There was no statistical difference in age and constituent ratio of gender between the 2 groups(49.80±11.72 vs 43.60±12.09 years,t=1.044,P=0.305; χ2=0.000,P=1.000).The indwelling time of HCSs was longer in difficult removal group compared to normal removal group(14.78±3.08 vs 16.10±1.14 months,t=2.550,P=0.016).The screws were applied to lateral malleolus(33),medial malleolus(39)and posterior malleolus(5)in normal removal group and the screws were applied to lateral malleolus(1),medial malleolus(4)and posterior malleolus(5)in difficult removal group.There was statistical difference in location of screws between the 2 groups(P=0.001).The proportions of screws applied to the posterior malleolus(50%)and medial malleolus(9.3%)were higher in difficult removal group compared to normal removal group.Conclusion:Internal fixation with 3.5-mm diameter full-thread hollow HCSs for treatment of ankle fracture has a high risk of subsequent difficulty in removal of HCSs.Overlong indwelling time of HCSs and applying HCSs to posterior malleolus and medial malleolus would increase the difficulty in removal of HCSs.

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通訊作者:金立昆 E-mail:[email protected]
更新日期/Last Update: 2021-02-20