重建髓内钉内固定与钢板固定结合空心钉治疗同侧股骨干骨折合并股骨颈骨折临床效果比较  

Clinical effect of reconstruction of intramedullary nail fixation and plate fixation+cannulated screw in the treatment of ipsilateral femoral shaft and neck fractures

作　　者：吕志强 李兴华 Lyu Zhiqiang;Li Xinghua(First Department of Lower Extremety,Affiliated Zhengzhou Orthopedic Hospital,Henan University,Zhengzhou 450052,China;Department of Bonesetting,Affiliated Zhengzhou Orthopedic Hospital,Henan University,Zhengzhou 450052,China)

机构地区：[1]河南大学附属郑州市骨科医院下肢Ⅰ科,450052 [2]河南大学附属郑州市骨科医院正骨科,450052

出　　处：《中华实验外科杂志》2022年第5期975-978,共4页Chinese Journal of Experimental Surgery

摘　　要：目的对比分析重建髓内钉内固定与钢板固定结合空心钉在同侧股骨干骨折(FFS)合并股骨颈骨折(FNF)治疗的临床效果。方法选入2013年10月至2015年10月我院收治的同侧FFS合并FNF患者40例,随机平均分为重建髓内钉内固定治疗组20例(A组)和钢板固定结合空心钉治疗组(B组)。比较两组手术时间和术中出血量,采用骨折愈合时间、完全负重时间、关节功能评分、日常生活活动评级等评价两组治疗效果,比较两组并发症发生情况。结果A组手术时间[(103.39±11.12)min比(117.24±14.87)min]、术中出血量[(272.63±76.85)ml比(426.42±161.47)ml]分别明显低于B组(P<0.05)。A组患者FFS愈合时间[(23.47±2.12)Wk比(24.08±2.46)Wk]、FNF愈合时间[(13.61±1.83)Wk比(14.19±1.90)Wk]、完全负重时间[(24.02±3.17)Wk比(25.64±3.35)Wk]、髋关节功能评分[(89.85±8.34)分比(86.26±9.04)分]、膝关节功能评分[(84.03±6.84)分比(81.80±7.32)分]、日常生活活动评级以及并发症总发生率(15.0%比25.0%),虽在数值上分别优于B组,但并无统计学意义(P>0.05)。结论重建髓内钉内固定与钢板固定结合空心钉在治疗同侧FFS合并FNF中具有相似的临床效果,但前者手术时间更短、术中出血量更少。Objective To compare the clinical effect of reconstruction of intramedullary nail fixation and plate fixation combined with cannulated screw in the treatment of ipsilateral femoral shaft and neck fractures(FFS and FNF).Methods A total of 40 patients with ipsilateral FFS and FNF in our hospital from October 2013 to October 2015 were randomly divided into group A(n=20)and group B(n=20).Group A was treated with reconstruction of intramedullary nail fixation,and group B was treated with plate fixation combined cannulated screw.The treatment effects of the two groups were compared.Results The operative time[(103.39±11.12)min vs.(117.24±14.87)min]and bleeding volume[(272.63±76.85)ml vs.(426.42±161.47)ml]in group A were significantly decreased as compared with those in group B(P<0.05).Although the healing time of FFS[(23.47±2.12)vs.(24.08±2.46)weeks],the healing time of FNF[(13.61±1.83)vs.(14.19±1.90)weeks],full weight-bearing time[(24.02±3.17)vs.(25.64±3.35)weeks],hip joint function scores[(89.85±8.34)vs.(86.26±9.04)],knee joint function scores[(84.03±6.84)vs.(81.80±7.32)],activities of daily living and total complication rate(15.0%vs.25.0%)in group A were superior to those in group B,there was no statistically significant difference(P>0.05).Conclusion The reconstruction of intramedullary nail fixation and plate fixation+cannulated screw in the treatment of ipsilateral FFS and FNF has similar clinical effects,but the former has shorter operation time,less bleeding,which is conducive to fracture healing.

关 键 词：股骨干骨折 重建髓内钉 锁定加压钢板 空心钉 

分 类 号：R687.3[医药卫生—骨科学]