成人闭合性股骨干骨折急性骨丢失的临床研究  

Clinical Study of Acute Bone Loss in Adult Closed Femoral Shaft Fractures

作　　者：高飞[1] 刘晓强[1] 王洪伟[1] 段洪凯[1] 李铠湘 谷昌伟 钟章华 GAO Fei;LIU Xiaoqiang;WANG Hongwei(Dongguan Tungwah Hospital,Dongguan 523000,China)

机构地区：[1]广东省东莞东华医院,广东东莞523000

出　　处：《中国医学创新》2018年第6期64-68,共5页Medical Innovation of China

基　　金：东莞市社会科技发展项目(201510515000735)

摘　　要：目的:探讨交锁髓内钉和锁定钢板两种内固定方式对成人股骨干骨折术后骨折端局部骨密度变化,以期为股骨干骨折内固定方式的选择提供指导依据。方法:回顾性分析2014年1月-2017年3月本院股骨干骨折患者33例的临床资料,按照治疗方法不同分为交锁髓内钉组(A组)18例和锁定钢板固定组(B组)15例。比较两组术后1、3个月的骨折端骨密度变化值(ROI 1)、骨折近端骨密度变化值(ROI 2)、骨折远端骨密度变化值(ROI 3)。结果:术后1个月,A组ROI 1大于B组,ROI 2、ROI 3均小于B组,但比较差异均无统计学意义(P>0.05);术后3个月,A组ROI 1大于B组,但比较差异均无统计学意义(P>0.05),ROI 2、ROI 3均小于B组,比较差异均有统计学意义(P<0.05)。结论:交锁髓内钉与锁定钢板两种固定方式治疗股骨干骨折,但交锁髓内钉固定患者骨丢失量少于锁定钢板组,因此建议交锁髓内钉为治疗成人股骨干骨折的首选。Objective:To investigate the changes of local bone mineral density after the treatment of adult closed femoral shaft fractures by interlocking intramedullary nail and locking plate,in order to provide guidance for the selection of internal fixation methods for femoral shaft fractures.Method:The clinical data of 33 patients with femoral shaft fracture from January 2014 to March 2017 in our hospital were retrospectively analyzed.According to different treatment methods,they were divided into 18 cases of interlocking intramedullary nail group(group A)and 15 cases of locking plate fixation group(group B).The changes of bone mineral density at the end of fracture(ROI 1),changes of bone mineral density in the proximal end of fracture(ROI 2),changes of bone mineral density at the distal end of fracture(ROI 3)after operation 1 and 3 months between two groups were compared.Result:After operation 1 month,the ROI 1 in group A was higher than that of group B,ROI 2 and ROI 3 were smaller than that of group B,but the differences were not statistically significant(P>0.05).After operation 3 months,the ROI 1 in group A was higher than that of group B,but the difference was not statistically significant(P>0.05),ROI 2 and ROI 3 were smaller than that of group B,the differences were statistically significant(P<0.05).Conclusion:Interlocking intramedullary nail and locking plate are the two fixation methods for femoral shaft fractures,but the bone loss of interlocking intramedullary nail fixation is less than that of locking plate group.so,it is suggested that interlocking intramedullary nail is the first choice for adult femoral shaft fractures.

关 键 词：股骨干骨折 锁定钢板 交锁髓内钉 骨丢失 双能X线吸收法 

分 类 号：R687.3[医药卫生—骨科学]