改良原甲板回植法修复甲床损伤.pdf

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1、·406·JournalofPracticalOrthopaedicsVo1．21，No．5，May．2015文章编号：1008—5572(2015)05—0406—04改良原甲板回植法修复甲床损伤蔺楚，朱涛，李强，孙雪生(山东省莱芜市人民医院，泰山医学院附属莱芜医院骨二科，271199)摘要：目的探讨利用改良原甲板回植法治疗甲床损伤的临床疗效。方法选取2013年6月至2014年6月间入院甲床损伤患者共68例74指，男42例，女26例；年龄1l～68岁，平均40．2岁。其中改良组(34例37指)采用剪除部分原甲板远端后原

2、位贴附、简单固定的改良回植方法治疗；传统组(34例37指)采用修复甲床后油纱覆盖、包扎传统方法治疗。评价两组治疗并发症发生率，新生甲外形采用吕桂欣疗效评价标准评定优良率。结果改良组发生甲床坏死或创面感染并发症发生率明显低于传统组，差异有统计学意义。两组患者均得到术后随访3～5个月，采用吕桂欣疗效评价标准对新生甲进行评定：改良组37指中优良35指，差2指，优良率94．6％；传统组37指中，优良30指，差7指，优良率81．1％。改良组新生甲外形优良率明显高于传统组，差异有统计学意义。结论与传统方法相比，改良原甲板回植法是修复

3、甲床损伤更为有效的方法，操作简单，创伤小，并发症少，新生甲外形更优良。关键词：甲床损伤；回植；甲板中图分类号：R616．2文献标识码：BNailBedInjuriesTreatedwithModifiedOriginalNailPlateReplantationLinChu，ZhuTao，LiQiang，etal(ThesecondDepartmentofOrthopedics，thePeoplesHospitalofLaiwaCity，theAffiliatedLaiwuHospitalofTaishanMedical

4、College，Laiwu271199，China)Abstract：ObjectiveTodiscussthetherapeuticeffectofthetreatmentofinjuriednailbedwithmodifiedoriginalnailplatereplantation．netbodsFromJune2013toJune2014。74fingersnailbedinjuriesin68caseswereinvolvedinthestud—Y，including42malesand26females．A

5、mongthem，themodifiedgroupincluding37fingersin34casesunderwentthemodifiedwereplantationmethodofthedistaloriginalnailplatepartalprunedandwereattchedinsituwithsimplefixationtorepair．Thetraditionalgroupincluding37fingersin34casestreatedwiththetraditionalmethodunderwe

6、ntthevaselinedauzestodressthesuturednailbeds．Theincidenceofcomplicationsandthegoodorexcellentrateofnewnailsevaluatedaccordingtotheassess-mentcriteriaofLvgui—xinwerecomparedbetweenthetwogroups．ResultsTheincidenceofnailbednecrosisandinfectioncomplicationsinthemodif

7、iedgroupwassignificantlylowerthanthatinthetraditionalgroup，thedifferencewasstatisticallysig—nificant．A11thecasesintwogroupswerefollow—upfor3to5months．thenewnailswereevaluatedaccordingtotheassessmentcriteriaformulatedbyLvgui—xin：theresultsof37fingersinthemodifiedg

8、roupweregoodorexcellentin35fingers，fairin2fingers，thegoodorexcellentratewas94．6％；theresultsof37fingersinthetraditionalgroupweregoodorexcellentin30fin—gers，fair