股骨闭合复位器辅助复位股骨交锁髓内钉固定治疗股骨干骨折的临床疗效分析  

Clinical effect of locking intramedullary nail fixation with reset of closed reductional device for treatment of femoral shaft fracture

作　　者：沙卫平[1] 赵科平[1] 陈国兆 王黎明[1] SHA Wei.ping;ZHAO Ke.ping;CHEN Guo.zhao;WANG Li.ming(Department of Orthopaedics,the First People.s Hospital of Zhangjiagang,Zhangjiagang 215600,China)

机构地区：[1]张家港市第一人民医院骨科,江苏张家港215600

出　　处：《骨科》2018年第6期458-463,共6页ORTHOPAEDICS

摘　　要：目的探讨股骨闭合复位器辅助复位股骨交锁髓内钉固定治疗股骨干骨折的临床疗效。方法回顾性分析手术治疗股骨干骨折的100例病人,其中股骨闭合复位器辅助复位股骨交锁髓内钉固定50例(复位器辅助组),单纯牵引架牵引复位股骨髓内钉固定50例(牵引架辅助组),比较两组的手术时间、出血量、导针反复进针次数、骨折愈合时间、需要骨折断端切开辅助复位例数及术后并发症发生率。结果随访时间为12～18个月。复位器辅助组:骨折均愈合,愈合时间为4～8个月,无感染、内外翻、短缩畸形发生,术后Harris髋关节评分及美国特种外科医院(Hospital for Special Surgery, HSS)膝关节评分优良率均达92.0%。牵引架辅助组:发生骨不连1例,余病人骨折均愈合,愈合时间为4～9个月,无感染发生,无内外翻、短缩畸形发生,Harris及HSS评定标准优良率均达88.0%。两组手术时间、出血量、导针反复进针次数、骨折断端切开辅助复位例数比较,差异均有统计学意义(t=10.699,P<0.001;t=22.517,P<0.001;t=3.010,P=0.003;χ~2=6.383,P=0.012)。骨折愈合时间、并发症发生率、髋膝关节功能优良率比较,差异均无统计学意义(t=0.646,P=0.520;χ~2=1.010,P=0.315;χ~2=0.444,P=0.505)。结论股骨闭合复位器辅助复位股骨交锁髓内钉固定治疗股骨干骨折,操作简便、创伤小、效果可靠。Objective To assess the effects of locking intramedullary nail fixation with reset of closed reduction device for the treatment of femoral shaft fractures. Methods This study retrospectively analyzed 100 femoral shaft fracture cases that underwent locking intramedullary nail fixation： 50 cases with reset of closed reduction device （experimental group）, and 50 cases with treatment of traction bed （control group）. Operating time, blood loss, needle use frequency, fracture healing time, number of open reductions required, and complication incidence were compared between the two groups. Results The followed.up time of patients was 12.18 months. In the experimental group, all patients were healed within 4 to 8 months. In the control group, all patients were healed except one case of nonunion, also within 4 to 9 months. No infection, valgus deformity,coxa vara, or shortening occurred in both groups. Rates of excellent hip and knee functions evaluated by Hip Harris Score and Hospital for Special Surgery （HSS） were 92.0% and 88.0% in the experimental and control groups, respectively. The operating time, blood loss, needle use frequency and number of open reductions required were significantly different between the two groups （t=10.699, P〈0.001; t=22.517, P〈0.001; t=3.010, P=0.003; χ2=6.383, P=0.012）. Meanwhile, fracture healing time, complication incidence, and hip and knee functions showed no significant differences （t=0.646, P=0.520; χ2=1.010, P=0.315; χ2=0.444, P=0.505）.Conclusion Locking intramedullary nail fixation with reset of closed reduction device is a convenient, trauma.free, effective, and reliable method for the treatment of femoral shaft fractures.

关 键 词：股骨干骨折 股骨闭合复位器 髓内钉 

分 类 号：R687.3[医药卫生—骨科学]