闭合复位带锁髓内钉固定治疗A型与C型股骨干骨折的疗效比较  

Comparative analysis of closed reduction and interlocking intramedullary nail fixation in the treatment of type A and type C femoral shaft fractures

作　　者：范智勇 孙加伟 黎丹东 王华[1] Fan Zhiyong;Sun Jiawei;Li Dandong;Wang Hua(Department of Orthopedics,the 83rd Group Military Hospital of the PLA,Xinxiang,Henan 453000,China;91 Unit of 32147 Unit of the 83rd Group Army of the PLA,Baoji,Shaanxi 721000,China)

机构地区：[1]中国人民解放军陆军第八十三集团军医院骨科,河南新乡453000 [2]中国人民解放军陆军第八十三集团军32147部队91分队,陕西宝鸡721000

出　　处：《创伤外科杂志》2022年第9期654-658,共5页Journal of Traumatic Surgery

摘　　要：目的比较闭合复位带锁髓内钉固定治疗A型与C型股骨干骨折的临床疗效。方法回顾性分析2014年5月—2020年1月解放军陆军第八十三集团军医院骨科行闭合复位带锁髓内钉内固定治疗的A型和C型(AO分型)闭合性股骨干骨折患者87例,根据骨折类型不同,分为A型骨折组和C型骨折组。A型骨折组46例,男性31例,女性15例;年龄18~60岁,平均38.1岁;道路交通伤21例,高处坠落伤12例,摔伤9例,重物砸伤4例。C型骨折组41例,男性32例,女性9例;年龄18~60岁,平均39.6岁;道路交通伤25例,高处坠落伤14例,重物砸伤2例。比较两组手术时间、出血量、膝关节美国特种外科医院(HSS)评分、骨折愈合时间、骨折愈合率等指标,评价术后疗效。结果患者随访18~24个月,平均20.3个月。A型骨折组与C型骨折组平均手术时间[(92.3±18.7)min vs.(96.0±22.0)min]、出血量[(162.39±66.07)mL vs.(174.10±69.68)mL]、HSS评分[(94.4±4.7)分vs.(94.6±3.6)分]比较,差异均无统计学意义(P>0.05)。A型骨折组与C型骨折组骨折愈合时间[(11.3±4.2)个月vs.(9.1±4.5)个月]、骨折愈合率(80.4%vs.95.1%)比较差异有统计学意义(P<0.05)。结论A型股骨干骨折相对C型股骨干骨折行闭合复位带锁髓内钉固定治疗,骨折愈合时间长,不愈合率高,采用髓内钉动力化可以提高A型股骨干骨折的骨折愈合率。Objective To investigate the clinical effect of closed reduction and interlocking intramedullary nailing in the treatment of type A and type C femoral shaft fractures.Methods A retrospective analysis was made on 87 cases of adult femoral shaft fractures of type A and type C(AO classification)who were treated with closed reduction and interlocking intramedullary nailing and followed up in the 83rd group Military Hospital of the PLA from May 2014 to Jan.2020.According to the fracture types,patients were divided into type A fracture group and type C fracture group.There were 46 cases in type A fracture group,including 31 males and 15 females,with an average of 38.1 years(range,18-60 years),including 21 cases of traffic accidents injuries,12 cases of falling from height,9 cases of falling and 4 cases of heavy objects smash injuries.There were 41 cases in type C fracture group,including 32 males and 9 females,with an average of 39.6 years(range,18-60 years),including 25 cases of traffic accidents injuries,14 cases of falling from height,and 2 cases of heavy objects smash injuries.The operation time,blood loss,knee HSS(hospital for special surgery)score,fracture healing time and fracture healing rate of the two groups were compared.Results The patients were followed up for 18-24 months,with an average of 20.3 months.There was no statistical difference in the average operation time(92.3±18.7)minutes vs.(96.0±22.0)minutes,blood loss(162.39±66.07)mL vs.(174.10±69.68)mL,HSS score(94.4±4.7)points vs.(94.6±3.6)points in type A fracture group and type C fracture group(P>0.05).The fracture healing time of type A fracture group and type C fracture group was(11.30±4.20)months vs.(9.12±4.46)months,and the fracture healing rate was 80.4%vs.95.1%,respectively,with statistically significant difference(P<0.05).Conclusion Compared with type C femoral shaft fracture,type A femoral shaft fracture is treated with closed reduction and interlocking intramedullary nail fixation.The fracture healing time is long and the non-healing r

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]