髓内扩张自锁钉治疗股骨干骨折术后钢板断裂临床观察  

Clinical assessment of intramedullary expand self-locking nail for fail internal fixation with plate in femoral shaft fracture

作　　者：范朝铭 王劲乐[1] 孙栋[1] 霍红军[1] 汤永安[1] 路坦[2] 

机构地区：[1]陕西省咸阳市第一人民医院骨二科 [2]新乡医学院第一附属医院骨外科,新乡453100

出　　处：《陕西医学杂志》2016年第5期587-589,共3页Shaanxi Medical Journal

基　　金：河南省医学科技攻关计划项目(201304029)

摘　　要：目的：探讨髓内扩张自锁钉用于治疗股骨干骨折术后钢板断裂的有效性和安全性。方法：对24例股骨干骨折钢板内固定术后断裂患者行髓内扩张自锁钉内固定手术,如出现骨折断端骨缺损则采用自体髂骨植骨。手术结束后记录手术时间、术中出血量,所有患者于术后1年进行随访,临床疗效评价参照Karlstrom-Olerud股骨骨折疗效评价标准。结果：所有患者均顺利完成手术,平均手术时间为131（94~146）min,平均术中出血量为300（200~550）ml。术后1年随访可见骨折愈合良好。Karlstrom-Olerud疗效评价,优14例,良7,可3例,差0例,优良率为87.5%。随访期间3例患者出现活动时轻度疼痛,经口服非甾体类药物好转;2例患者出现患侧膝关节僵硬、活动受限,经理疗及康复锻炼后好转。结论：采用髓内扩张自锁定治疗股骨干骨折术后钢板断裂,为骨折的愈合提供良好的力学基础,是一种安全有效的治疗方法。Objective：To investigate the application of intramedullary expand self-locking nail（IESN）in fail internal fixation with plate in femoral shaft fracture.Methods：From 2010~2014,a total of 24 patients were retrospectively reviewed,diagnosed as fail internal fixation with plate of femoral shaft fracture.All the cases were treated with IESN,and bone transplatation with iliac autograft was performed,if necessary.Duration of operation and intraoperatve blood loss were recorded.Follow-up was done at 1year after the procedure,X-ray was arranged to observe fracture healing and clincial assessment was performed according to Karlstrom-Olerud score.Results：The average of operative duration was 131（94~146）min,and intraoperatve blood loss was 300（200~550）ml.There was evidence of fracture healing of every case at the 1year＇s follow-up.For Karlstrom-Olerud score,there were 14 cases of excellent,7cases of good,3cases of fair,and none of poor.Three cases suffered from limited motion of knee joint and 2cases suffered from mild limb pain,who were cured by symptomatic treatment.Conclusion：Our study reveals that the outcomes of IESN is satisfactory,for fail internal fixation with plate in femoral shaft fracture.

关 键 词：股骨骨折/外科学 骨折固定术 髓内 @钢板断裂 @髓内扩张自锁钉 

分 类 号：R683.42[医药卫生—骨科学]