股骨闭合复位器联合股骨交锁髓内钉固定治疗股骨干骨折的临床观察  

Clinical observation of closed reduction device for femur combined with femoral interlocking intramedullary nail fixation for femoral shaft fracture

作　　者：赵赞栋 秦妮 冯东旭 ZHAO Zan-dong;QIN Ni;FENG Dong-xu(Department of Hand Surgery,Honghui Hospital Affiliated to Xi an Jiaotong University,Xi an 710054;Department of Critical Care Medicine,Xi an Central Hospital,Xi an 710004,China;Upper Limb Disease Area of Traumatic Orthopaedics Department,Honghui Hospital Affiliated to Xi an Jiaotong University,Xi an 710054,China)

机构地区：[1]西安交通大学附属红会医院手外科,西安710054 [2]西安交通大学附属红会医院创伤骨科上肢病区,西安710054 [3]西安市中心医院重症医学科,西安710004

出　　处：《创伤外科杂志》2019年第11期812-815,共4页Journal of Traumatic Surgery

基　　金：陕西省科学技术研究发展计划(2015SF039)

摘　　要：目的探讨股骨闭合复位器联合股骨交锁髓内钉固定治疗股骨干骨折的疗效。方法2014年1月-2017年12月西安交通大学附属红会医院收治股骨干骨折患者104例,均为闭合性骨折,其中男性70例,女性34例;年龄20~60岁,平均31.9岁。随机数字表法分为对照组和实验组,各52例,对照组给予牵引床辅助交锁髓内钉固定,实验组给予闭合复位器联合交锁髓内钉固定,记录并比较两组手术时间、术中出血量、术中透视次数、导针进针次数、骨折断端切开复位例数、骨折愈合时间、术后并发症情况以及髋、膝关节功能评分。结果随访时间为12~18个月,两组术后负重时间均为12~16周,均无感染发生。实验组与对照组手术时间[(73.1±5.7)min vs.(82.4±6.1)min]、出血量[(106.75±22.83)mL vs.(174.32±26.41)mL]、透视次数[(4.26±1.47)次vs.(8.73±2.36)次]、进针次数[(1.83±1.15)次vs.(5.73±1.25)次]、切开复位比例(0%vs.5%)比较,差异有统计学意义(P<0.05);两组患者术后愈合时间、并发症发生率、髋膝功能评分比较差异无统计学意义(P>0.05)。结论闭合复位器联合交锁髓内钉固定治疗股骨干骨折能够有效提高复位满意度和进针准确度,减少手术时间、出血量,提高手术效率,且不影响骨愈合,具有较高的应用价值,值得临床推广。Objective To study the clinical effect of closed reduction device for femur combined with femoral interlocking intramedullary nail fixation for femoral shaft fracture.Methods Totally 104 patients with femoral shaft fracture were admitted into our hospital from Jan.2014 to Dec.2017 and were randomly divided into control group and observation group.There were 70 males and 34 females,with an average age of 31.9 years(range,20-60 years).Patients in the control group were treated with traction bed assisted interlocking intramedullary nail fixation,while patients in the observation group were given closed reduction device combined with femoral interlocking intramedullary nail fixation.The operation time,intraoperative bleeding volume,intraoperative fluoroscopy times,needle insertion times,cases of open reduction of fracture ends,fracture healing time,postoperative complications,hip and knee joint function score were recorded and compared between the two groups.Results Patients were followed up for 12-18 months,and the weight-bearing activities began at postoperative 12-16 months.The operation time,bleeding volume,fluoroscopy times,needle insertion times and the ratio of open reduction in the observation group were significantly better than those in the control group(all P<0.05).There was no significant difference in healing time,complication rate and hip and knee function score between the two groups.Conclusion Closed reduction device combined with femoral interlocking intramedullary nail fixation for femoral shaft fracture can effectively improve reduction satisfaction and accuracy of needling,reduce operation time and bleeding volume,improve operation efficiency without affecting bone healing.It has high application value and is worthy of clinical promotion.

关 键 词：股骨干骨折 闭合复位 髓内钉 内固定 

分 类 号：R683.42[医药卫生—骨科学]