闭合复位带锁髓内钉治疗股骨干骨折  

Treatment of femoral shaft fractures by closed reduction and interlocking intramedullary nailing

作　　者：朱治国[1] 于远洋[1] 侯林俊[1] 盖伟[1] 杨勇[1] 

机构地区：[1]首都医科大学良乡教学医院骨一科,北京102400

出　　处：《中国骨伤》2014年第10期819-822,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的：探讨闭合复位带锁髓内钉治疗股骨干骨折的临床疗效.方法：自2006年3月至2011年12月采用闭合复位带锁髓内钉治疗103例股骨干骨折患者,其中男76例,女27例;年龄19～55岁,平均36岁.按照AO分型：A型64例,B型27例,C型12例;开放性骨折13例（Gustilo Ⅰ型5例,Ⅱ型8例）.观察术后患者骨折愈合时间,并采用膝关节HSS评分标准对术后1年膝关节功能恢复情况进行评价.结果：术中发生股骨颈骨折1例,股骨近端骨折1例,均于术中更换重建钉固定,术后骨折愈合.术中发生腓总神经损伤1例,营养神经治疗4个月后恢复.103例患者全部获得随访,时间12～28个月,平均22个月.全部患者获得骨性愈合,愈合时间3～9个月,平均5个月.髋关节功能全部恢复正常,术后1年膝关节行HSS评分平均90.89±5.06.结论：注重手术操作,力求闭合复位,减少并发症,带锁髓内钉是治疗股骨干骨折的首选方法.Objective：To discuss the clinical effect of closed reduction and interlocking intramedullary nailing in the treatment of femoral shaft fracture.Methods：From March 2006 to December 201 1,103 patients with femoral shaft fracture were treated by closed reduction and interlocking intramedullary nailing including 76 males and 27 females with an average age of 36 years old ranging from 19 to 55 years old.According to AO classification,there were 64 cases with type A,27 with type B,12 with type C.Thirteen cases were open fractures including 5 cases with Gustilo type Ⅰ,8 with Gustilo type Ⅱ.The time of bone healing were observed after operation,the knee function recovery was evaluated by HSS scoring standard at 1 year after operation.Results：The intraoperative complications included femoral neck fracture in 1 case and proximal femoral fracture in 1 case,both of the patients were treated with reconstructive intramedullary interlocking nail and the fractures healed postoperatively.One patient was suffered from common peroneal nerve injury,which were fully recovered at 4 months＇ later after medical treatment.All the patients were followed up from 12 to 28 months （averaged 22 months）.All of the fractures were healed well and the average healing time was 3 to 9 months （averaged 5 months）.All the hip joints were recovered to normal function.The average HSS was 90.89±5.06 at 1 year after operation.Conclusion：Interlocking intramedullary nailing is the preferred treatment for patients with femoral shaft fracture.Carefully operating and closed reduction can reduce the complications.

关 键 词：股骨骨折 骨牵引复位法 骨折固定术 髓内 外科手术 

分 类 号：R683.42[医药卫生—骨科学]