仰卧位与侧卧位闭合复位髓内钉内固定治疗股骨干骨折的疗效比较  

Closed reduction at the supine position versus at the side-lying position in intramedullary nailing for femoral shaft fractures

作　　者：魏俊强[1] 刘利蕊[2] 潘进社[3] 金宇[1] 闫石[1] 李衡[3] 吴希瑞[3] 张英泽[3] 

机构地区：[1]承德医学院附属医院骨四科,河北省承德市067000 [2]承德医学院附属医院儿科,河北省承德市067000 [3]河北医科大学第三医院创伤急救中心、河北省骨科生物力学重点实验室

出　　处：《中华创伤骨科杂志》2013年第8期660-665,共6页Chinese Journal of Orthopaedic Trauma

基　　金：河北省自然科学基金（c2010000585）

摘　　要：【摘要】目的比较仰卧化与侧卧位闭合复化髓内钉内同定治疗股骨干骨折的近期疗效。方法 回顾性分析2007年6月至2010年9月采用髓内钥内固定的71例股骨干骨折患行资料，根据术中怵位小H分为两组：仰卧位组33例，男26例，女7例；平均年龄为（39．2±9．6）岁；骨折AO分型：A型15例，B型9例，C制9例。侧卧位组38例，男29例，女9例；甲均年龄为（42．2±10．1）岁；骨折AO分剐：A掣14例，B型10例，C型14例、记求jr比较两组患者的手术时间、术中出血量、术中透视时间、改为切＂复位内同定的病例数、近期并发疵、住院时间及骨折愈合时间等。结果71例患各术后i夫12～26个月（平均20个月）随访、，仰卧位组忠并下术时间[（139．9±46．8）min】和术叶1透视时间【（191．4±78．6）s1较侧卧位组I（75．5±18．1）rain、（93．3±27．1）S]长，术中出血量【（176．5±103．0）m1．】较侧卧位组【（132．5±42．7）ml。1多，两组间比较蔗蚌均订统计学意义（P〈0．05）。仰卧位组与侧卧位组患者住院时间和骨折愈合时间比较筹异均无统计学意义（P〉0．05）。仰卧化纰3例忠者术中改为切开复位髓内钉因定。两组患者均未出现近期并发癌，结论侧卧化例合复化髓内钥。同定治疗股骨干骨折尤需牵引床，具有手术时间短、创伤小及接受X线辐射艟少等优点，是一种较好的术式选择。Objective To compare Ihe short-term outcomes of closed reduction at the supine versus side-lying position in the intramedullary nailing for femoral shaft fi＇actures. Methods A retrospective review was conducted of 71 patients with f^moral shaft fracture who had been treated with closed reduction at the supine or side-lying position before intramedullary femoral nailing from June 2007 to September 2010. They were divided inlo 2 groups according to their reduction position. In the supine group there were 26 men and 7 women, with an aw^rage of 39.2＋9.6 years, and 15 cases of type A, 9ones of type B and9ones of type C by lhe AO classification. In the side-lying group, there were 29 males and 9 females, with an average of 42.2 ＋ 10. 1 years, and 14 cases of type A, 10 ones of lype B and 14 ones of type C. The 2 groups were compared in terms of operation time, intranperative blood [nss, intraoperative fluoroscopy time, cases who changed to open reduction, postoperative ,.~umplications, hospital stay and fracture healing time. Results The 71 patients were followed for 12 to 36 months （average, 20 months）. Cumpared with the side-lying group, the supine group had significantly longer operation time （ 139.9 ＋46.8 minutes versus 75.5 -＋ 18. 1 minutes） and fluoroscopy time （191.4 ＋ 78.6 seconds versus 93.3 -＋ 27. 1 seconds）, and significantly more blood loss （176.5 -＋ 103.0 milliliters versus 132.5 ＂4＂ 42.7 milliliters） （ P 〈 0.05）. There were no significant differences regarding hospital stay or fi＇aeture healing time between the 2 groups （ P 〉 O. 05）. Three eases changed into open reduclion in the supine group and no ease did in the side-lying group. No shnrt-term complications happened after operation in the 2 groups. Conclusion In the intramedullary nailing of femoral shaft fractures, closed re- duction at the side-lying position is a good alternative because il has advantages of less blood loss, shorter op- eration time anti fluoroscopy time, fewcx complications and unne

关 键 词：股骨骨折 骨折固定术 髓内 骨钉 体位 

分 类 号：R687.3[医药卫生—骨科学]