两种微创内固定治疗股骨中下段骨折疗效分析  

Selective analysis of the distal fracture of femur of two minimally invasive internal fixation formula

作　　者：舒荣兵[1,2] 程细高[1] 吕仁发[2] 刘继春[2] 周江军[2] 刘加钱[2] 吴刚[2] 刘荣[2] 

机构地区：[1]南昌大学第二附属医院骨一科,330006 [2]解放军第184医院骨科,江西鹰潭335000

出　　处：《中华临床医师杂志（电子版）》2015年第7期1-4,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：南京军区医学科技创新课题面上A类(10MA058)

摘　　要：目的比较微创锁定钢板与逆行髓内钉对股骨中下段骨折治疗的临床疗效。方法回顾性分析使用微创锁定钢板与髓内钉对95例股骨中下段骨折进行治疗的临床效果,45例患者行髓内钉固定治疗,50例患者使用微创结合锁定钢板固定治疗,统计两组患者的术中出血量、手术时间、术中透视次数、术后并发症、骨折愈合时间、膝关节功能评分等,经统计学处理得出观察结果。结果 95例患者完成住院观察,3例失随访,逆行髓内钉组失访1例,微创锁定钢板组失访2例,患者随访时间10～24个月,平均随访13.4个月,微创锁定钢板的术后并发症、骨折愈合时间、两组膝关节功能评分无显著性差异（P〉0.05）,而两组术中平均出血量、术中手术时间、术中透视次数有显著性差异（P〈0.01）。结论微创锁定钢板与逆行髓内钉治疗股骨中下段骨折,均能达到治愈效果,但微创锁定钢板治疗在减少透视次数、缩短手术时间以及控制感染发生率等方面更具优势。Objective To discuss clinical effect of two kinds of minimally invasive surgery（the retrograde intramedullary needle and the minimally invasive plate osteosynthesis） in the treatment of distal fracture of femur. Methods We retrospectively analyzed 95 patients which we had used retrograde intramedullary needle and minimally invasive locking plate osteosynthesis treaded their femoral shaft fractures. The data of blood loss, operative time, radiation exposure, postoperative complications, union time, function of knee joint were recorded, and the function of knee joint was assessed according to Johner-wruhs＇. Results 95 cases completed hospital observation. 3 cases were lost to follow up, including1 retrograde intramedullary case and 2 minimally invasive plate osteosynthesis cases. There were significant differences in operative time, fluoroscopy times between two groups（P〈0.01）. There were no significant difference in average amount of bleeding, postoperative complications, fracture healing time,knee joint function score（P〉0.05）. Conclusions About two methods of retrograde intramedullary needle and minimally invasive locking plate have good healing effect for treating distal fracture of femur, but minimally invasive treatment locking plate has advantages in reducing the number of perspective, shorter operative time, and the incidence of infection control, etc.

关 键 词：股骨骨折 骨折固定术 外科手术 微创性 逆行髓内钉 锁定钢板 

分 类 号：R687.3[医药卫生—骨科学]