带锁髓内钉与加压钢板治疗股骨干骨折疗效比较  

Comparison of the clinical efficacy of interlocking intramedullary nailing and compression plate fixation for femoral shaft fracture

作　　者：李振刚[1] 周媛[1] 

机构地区：[1]天门市第一人民医院骨科,湖北天门431700

出　　处：《临床骨科杂志》2012年第5期535-536,539,共3页Journal of Clinical Orthopaedics

摘　　要：目的比较带锁髓内钉与加压钢板治疗股骨干骨折的临床疗效。方法选择股骨干骨折的患者84例,采用完全随机分组的方法分为两组:观察组42例,使用带锁髓内钉固定;对照组42例,使用加压钢板内固定。记录两组手术情况,观察术后骨痂生长情况,随访患肢膝关节功能恢复的时间。结果住院时间及术中失血量:观察组分别为(42.5±11.2)d和(283.4±23.7)ml,对照组分别为(55.4±12.1)d和(301.2±32.3)ml,观察组两项指标均低于对照组(P<0.05)。术后前2个月骨痂出现比例:观察组为90.5%,对照组为47.6%,观察组明显高于对照组(P<0.05)。膝关节恢复到30°、60°、90°、135°所需要的平均时间:观察组分别为(6.5±1.2)d、(9.7±1.8)d、(14.0±2.2)d、(27.8±5.4)d,对照组分别为(8.3±2.2)d、(11.6±3.3)d、(16.6±4.6)d、(35.7±8.6)d,观察组均短于对照组(P<0.05)。术后观察组患者均愈合良好,无并发症发生;对照组有1例出现切口感染,1例出现骨髓炎,2例出现骨不连。结论采用带锁髓内钉固定治疗股骨干骨折较加压钢板固定治愈率高,术后并发症少,可作为基层医院股骨干骨折治疗的首选方法。Objective To compare the clinical efficacy of interlocking intramedullary nailing and compression plate fixation for femoral shaft fractures. Methods 84 patients of femoral shaft fractures were randomized into 2 groups, 42 patients as the observation group using intramedullary nail, 42 cases as the control group using compression plate fixation. The conditions of the operation, X-ray of femoral shaft after operation, callus growth, and function recovery of knee were recorded. Results The hospitalized time, intraoperative blood loss of the observation group were （42. 5 ± 11.2） d and （283.4 ± 23.7） ml, the control group were （ 55.4 ± 12. 1 ） d and （ 301.2 ± 32. 3 ） ml, the two indicators of the observation group were both lower than the control group （ P 〈 0. 05 ） ; The callus ratio in the first two months of the observation group was 90. 5% , the control group was 47. 6% , which was higher in the observation group （P 〈0.05） ; In the observation group, the time of knee joint restore to 30°, 60°, 90°, 135° were （6. 5 ± 1.2）d, （9.7±1.8）d, （14.0±2.2）d, （27.8 ±5.4）d, in the control group were （8.3±2.2）d, （11.6±3.3）d, （ 16. 6 ± 4. 6） d, （ 35.7 ± 8.6） d, the observation group were lower than control group （P 〈 0. 05 ） ; The observation group was recover well, and no one occurred complications after the operation; in the control group, 1 occurred incisional infection, 1 occurred osteomyelitis, 2 occurred nonunion. Conclusions The cure rate of interlocking intramedullary nailing is higher than compression plate fixation treating, the complications after operation is fewer, it is the preferred method for primary hospital to cure femoral shaft fracture.

关 键 词：带锁髓内钉 加压钢板 股骨干骨折 病例对照研究 

分 类 号：R683.42[医药卫生—骨科学] R687.3[医药卫生—外科学]