| Objective:To compare the clinical effect of straight compression locking plate and nickel-titanium memory alloy sternal fixator in the treatment of sternal fracture.To explore the potential application value of nickel-titanium memory alloy sternal fixator in the treatment of sternal fracture,and to provide a better clinical idea for the treatment of sternal fracture with open reduction and internal fixation.Methods:A total of 127 patients who treated for sternal fracture(SF)in the Department of cardiothoracic Surgery or emergency Department of the Second Hospital of Shanxi Medical University in Taiyuan,Shanxi Province during 4 years from July 2018 to July 2022 were enrolled in this study.Of these patients,ninety-two were male(72.44%)and thirty-five were female(27.56%).The causes were traffic accidents in seventy-two cases(56.69 percent),falls from high altitudes in thirty-six cases(28.35 percent)and injuries caused by heavy objects in twelve cases(9.45%)and fall injuries occurred in seven cases(5.46%).Among them,74 patients underwent open reduction and internal fixation for sternal fracture after a series of detailed examinations including chest plain scan CT+ three-dimensional reconstruction of the chest.The clinical case data were retrospectively analyzed.According to the sternal fracture treated by different fixation methods,42 patients were divided into straight compression locking plate for sternal fracture treatment and nickel-titanium memory alloy sternal fixator for sternal fracture treatment 32 cases,and a lot score matched PSM for case matching,and finally included 30 cases in the research group(Ni-TI memory alloy sternum fixation device)and the control group(straight-type compression locking plate).Thirty cases.Blood gas analysis indexes(partial pressure of oxygen and partial pressure of carbon dioxide),time during operation,amount of blood loss during operation,subcutaneous drainage volume on the day of operation,visual analogue score(VAS),length of stay and wound healing grade of the two groups were seen before and after operation,respectively.To further study and explore the clinical efficacy of these two materials in the treatment of sternal fracture.Results:1.The general data of the two groups of patients like age,gender,BMI,cause of injury,whether to perform closed thoracic drainage,the number of rib fractures,these basic clinical data were analyzed and compared,the study group and the control group have differences,but these differences were not statistically significant(P>0.05);2.The operation time of the study group was significantly different from that of the control group,with reduced intraoperative blood loss,lower VAS pain score 2 days after surgery,shorter total hospital stay,and reduced subcutaneous drainage volume on the day of surgery,all of which were statistically significant(P<0.05).The difference of wound healing grade was also significant.The arterial oxygen partial pressure(Pa02)of the study group was higher than that of the control group,and arterial carbon dioxide partial pressure(Pa CO2)was lower than that of the control group at 3 days after surgery,and the difference was statistically significant(P<0.05).Conclusion:Traumatic sternal fracture is an acute injury which can endanger the life of patients.Correct treatment is the key to reduce the mortality.For patients in need of surgical treatment,the use of nickel-titanium memory alloy sternal fixator is effective,safe and reliable,can effectively improve the lung function and blood gas status of patients,can also effectively shorten the operation time and intraoperative blood loss,the accuracy of straight compression locking plate fixation is higher,the length of hospital stay will be shortened,the wound is not easy to open,and there is no need for secondary surgery internal fixation Removal,reduce the burden of patients,can promote the early recovery of patients,has high clinical application value. |
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