两种内固定方式治疗老年股骨干多段骨折的疗效比较  

Analysis of the curative effect of two internal fixation in the treatment of femoral shaft fracture in the elderly

作　　者：周海鹰 卓日波[2] 赵鹏 ZHOU Haiying;ZHUO Ribo;ZHAO Peng(Department of Orthopedics,Air Force General Hospital of PLA Southern Theater Command,Guangzhou,Guangdong,051000,China;不详)

机构地区：[1]中国人民解放军南部战区空军医院骨科,广东广州051000 [2]广东省第二人民医院创伤骨科,广东广州051000 [3]唐山市开滦总医院骨科,河北唐山063000

出　　处：《实用手外科杂志》2021年第3期336-338,共3页Journal of Practical Hand Surgery

摘　　要：目的比较股骨髓内钉及股骨解剖型锁定钢板在治疗老年股骨干多段骨折的疗效。方法对2017年1月-2020年1月收治的35例老年股骨干多段骨折病例资料进行回顾性分析,其中采用切开复位+钢板螺钉内固定治疗18例,采用髓内钉固定治疗17例。比较两组术前、术中情况及术后疗效。结果所有患者均获得随访。髓内钉内固定组手术切口及手术时间均短于钢板内固定组;髓内钉内固定组出血量明显小于钢板内固定组;髓内钉内固定组C臂机透视次数较钢板组增加,差异有统计学意义(P<0.05);髓内钉内固定组髋关节Harris评分优良率(88.2%)明显高于钢板内固定组(66.7%),且差异有统计学意义。结论对于老年股骨干多段骨折患者,采用髓内钉治疗术后效果明显优于钢板,但具体内固定的选择仍需以实际情况而定。Objective To compare the efficacy between femoral intramedullary nail and femoral anatomic locking plate in the treatment of elderly patients with multiple femoral shaft fractures.Methods A retrospective review of 35 elderly patients with femoral shaft multistage fractures admitted to our department from January 2017 to January 2020,it was analysed included 18 patients treated with open reduction plus plate and screw internal fixation and 17 patients treated with intramedullary nail.The preoperative,intraoperative and postoperative outcomes of the two groups were compared.Results All patients were followed up.The incision and operation time of the intramedullary nail internal fixation group were shorter than that of the plate internal fixation group,and the amount of blood loss of the intramedullary nail internal fixation group was significantly smaller than that of the plate internal fixation group,but the number of C-arm fluoroscopy of the intramedullary nail internal fixation group was higher than that of the plate internal fixation group,with statistically significant difference(P<0.05).The excellent and good Harris score of the hip joint in the intramedullary nail internal fixation group(88.2%)was significantly higher than that in the plate internal fixation group(66.7%),and the difference was statistically significant.Conclusion For the elderly patients with multiple femoral shaft fractures,the effect of intramedullary nail treatment is obviously better than the steel plate,but the specific choice of internal fixation still needs to be determined by the actual situation.

关 键 词：老年患者 股骨骨折 钢板 髓内钉 

分 类 号：R687.3[医药卫生—骨科学]