逆行交锁髓内钉和锁定钢板治疗股骨远端骨折的疗效  

Efficacy of retrograde intramedullary interlocking nail and locking plate in treatment of distal femoral fractures

作　　者：王全明[1] 齐新生[1] 茅治湘[1] 卢红文[1] 

机构地区：[1]江南大学附属医院骨科,江苏无锡214062

出　　处：《江苏医药》2018年第1期72-75,共4页Jiangsu Medical Journal

摘　　要：目的探讨逆行交锁髓内钉和锁定钢板在股骨远端骨折治疗中的临床疗效。方法78例股骨远端骨折患者随机分为逆行交锁髓内钉固定组(A组,40例)和锁定钢板固定组(B组,38例),比较两组手术时间、术中出血量、骨折愈合时间、并发症发生情况、改良美国特种外科医院(HSS)评分和膝关节活动度。结果 A组和B组手术时间、术中出血量、骨折愈合时间比较均无统计学差异[(108.2±17.6)min vs.(115.4±18.1)min、(328.0±52.4)ml vs.(324.6±56.6)ml、(20.3±9.6)周vs.(21.4±11.5)周](P>0.05);B组术后并发症发生率略高于A组(10.5%vs.2.6%)(P>0.05);而A组膝关节活动度和改良HSS评分均稍高于B组[(105.0±11.0)度vs.(99.1±23.5)度和(87.2±17.1)分vs.(85.6±11.2)分](P>0.05)。结论逆行交锁髓内钉和锁定钢板在治疗股骨远端骨折时都有良好疗效。逆行交锁髓内钉在膝关节功能、活动度方面优于锁定钢板,且并发症更少。Objective To investigate the clinical efficacy of retrograde intramedullary interlocking nail and locking plate in the treatment of distal femoral fractures.Methods A total of 78 patients with distal femoral fractures was randomly divided into two groups.Group A（40 cases）was treated with retrograde intramedullary interlocking nail and group B（38 cases）was treated with locking plate.The operation time,intraoperative blood loss,healing time of fracture,incidence of complications,modified Hospital for Special Surgery（HSS）score and range of motion were compared between two groups.Results There were no significant differences in operation time,intraoperative blood loss and healing time of fracture between groups of A and B[（108.2±17.6）minutes vs.（115.4±18.1）minutes,（328.0±52.4）ml vs.（324.6±56.6）ml and（20.3±9.6）weeks vs.（21.4±11.5）weeks]（P〈0.05）.The incidence of complications including deep infection and bone ununion after operation in group B was slightly higher than that in group A（10.5% vs.2.6%）（P〈0.05）.However,the range of motion and modified HSS score in group A were slightly higher than those in group B[（105.0±11.0）degrees vs.（99.1±23.5）degrees and（87.2±17.1）points vs.（85.6±11.2）points]（P〈0.05）.Conclusion Both retrograde interlocking intramedullary nail and locking plate have satisfactory clinical outcomes in the treatment of distal femoral fractures.Compared with locking plate,retrograde intramedullary interlocking nail has better improvement in knee function and mobility and lower complications.

关 键 词：股骨远端骨折 逆行交锁髓内钉 锁定钢板 

分 类 号：R683[医药卫生—骨科学]