摘要
目的:探讨肋弓骨折（CAF）的分型、内固定方法及其效果。方法:回顾性分析2017年5月至2022年5月沈阳医学院附属中心医院收治的71例内固定治疗的CAF患者，其中男性59例，女性12例；年龄17~86（49±4.3）岁。根据临床表现、骨折特点，将CAF分为单纯型和复合型。单纯型为单纯CAF或有肋骨与肋弓连接的肋软骨骨折；复合型为CAF合并有邻近肋弓8~10肋骨骨折。按照CAF、邻近肋软骨及肋骨骨折的伤情，进行细化分型，单纯型又分为CAFⅠ、CAFⅡ型，复合型又分为CAFⅢ、CAFⅣ型。71例患者均采用局部小切口、MatrixRIB进行内固定，一部分患者加用钢丝捆绑。结果:术后随访6个月至2年，全组患者疼痛消失，无畸形愈合，钛板无移位，钛钉无脱出。结论:CAF的分型对拟定手术方案、伤情评估及病例统计具有一定的临床意义。内固定治疗效果明显，避免了长期疼痛、不愈合或畸形愈合。
Abstract
Objective:To investigate the classification of costal arch fractures (CAFs), the internal fixation methods and its outcomes.Methods:We retrospectively analyzed 71 patients with CAF admitted to Central Hospital Affiliated to Shenyang Medical College for internal fixation from May 2017 to May 2022, including 59 males and 12 females, with a mean age of 49±4.3 years (age range, 17–86 years). According to the clinical manifestations and fracture characteristics, we classified CAFs as either simple or compound. The simple type refers to CAF alone or costal cartilage fractures with ribs attached to the costal arch; the compound type means CAF combined with fractures of 8–10 ribs of the adjacent costal arch. According to the severity of CAFs, and adjacent costal cartilage and rib fractures, the simple type is further divided into CAF Ⅰ and CAF Ⅱ, and the compound type into CAF Ⅲ and CAF Ⅳ. All 71 patients underwent internal fixation surgery using MatrixRIB under a small local incision, with some subjected to additional wire strapping.Results:The patients were followed up for 6 months to 2 years post operation. Until the last follow up, all patients had experienced no pain, without malunion, displacement of the titanium plate, and slipping of the titanium nail.Conclusions:The classification of CAFs has clinical significance for the development of surgical plans, injury assessment and case statistics. Internal fixation is an effective treatment, avoiding long-term pain, failure of healing, and malunion.
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