带锁髓内钉与钢板螺钉治疗闭合性股骨干骨折疗效分析  

Therapeutic effect of interlocking intramedullary nail and plate screw in the treatment of closed femoral shaft fracture

作　　者：高肇篷 吴彬[3] 贾代良 高明[3] 王海滨[3] GAO Zhaopeng;WU Bin;JIA Dailiang;GAO Ming;WANG Haibin(School of Clinical Medicine,,Jining Medical University,Jining 272067,China;The Affiliated Hospital of Jining Medical University,Jining 272029,China)

机构地区：[1]济宁医学院临床医学院,济宁272067 [2]济宁医学院 [3]济宁医学院附属医院,济宁272029

出　　处：《济宁医学院学报》2018年第6期413-416,421,共5页Journal of Jining Medical University

摘　　要：目的比较带锁髓内钉与钢板螺钉治疗闭合性股骨干骨折的疗效。方法回顾性分析2012年1月至2018年1月63例闭合性股骨干骨折内固定治疗的患者资料,根据股骨干手术方式不同分为观察组即采用带锁髓内钉内固定患者28例和对照组即采用钢板螺钉内固定患者35例,比较两组术中固定股骨干时的出血量、手术时间、骨折愈合时间、股骨干骨折愈合率、Karlstrom和Olerud股骨骨折疗效评价情况及术后并发症发生率等。结果所有患者术后获3～24个月随访。观察组出血量(215. 36±27. 10) ml较对照组(400. 00±43. 68) ml少,差异有统计学意义(P <0. 05)。股骨干骨折手术时间[(2. 38±0. 16) h vs (2. 72±0. 17) h]、骨折愈合时间[(14. 07±0. 68)周vs (15. 91±1. 25)周]、骨折愈合率(96. 4%vs 97. 1%),比较差异均无统计学意义(P>0. 05)。两组患者术后刀口均未出现感染,所有患者均达到Karlstrom和Olerud股骨骨折疗效评价标准的优良水平。结论与钢板螺钉内固定比较,带锁髓内钉治疗闭合性股骨干骨折具有出血量少的优势,但两者在骨折愈合率、骨折愈合时间、手术时间、术后并发症上并无明显差别,二者在治疗闭合性股骨干骨折上均可获得满意疗效。Objective To compare the efficacy of interlocking intramedullary nails and plate screws in the treatment of closed femoral shaft fractures.Methods A retrospective analysis of 63 patients with closed femoral shaft fractures from January 2012 to January 2018 was performed.According to the different methods of femoral shaft surgery,28 patients with internal fixation with interlocking intramedullary nail were included.In the control group,35 patients underwent internal fixation with plate screw group.The bleeding volume,operation time,fracture healing time,femoral shaft fracture healing rate,evaluation of Karlstrom and Olerud femur fractures,and postoperative complications were compared between the two groups as well as the incidence rate,etc.Results All patients were followed up for 3 to 24 months.The amount of bleeding in the observation group(215.36±27.10)ml was less than that in the control group(400.00±43.68)mL,and the difference was statistically significant(P<0.05).The operation time of femoral shaft fracture[(2.38±0.16)h vs(2.72±0.17)h],fracture healing time[(14.07±0.68)weeks vs(15.91±1.25)weeks]and fracture healing rate(96.4%Vs 97.1%)were not different significantly(P>0.05).There were no infections in the surgical margins of the two groups,and all patients achieved excellent levels of efficacy evaluation criteria for karlstrom and Olerud femur fractures.Conclusion Compared with the plate screw,the treatment of closed femoral shaft fracture with interlocking intramedullary nail has the advantage of less bleeding,but there is no significant difference in fracture healing rate,fracture healing time,operation time and postoperative complications.Satisfactory results can be obtained in the treatment of closed femoral shaft fractures.

关 键 词：股骨干 闭合性骨折 骨折内固定术 

分 类 号：O224[理学—运筹学与控制论]