交锁髓内钉治疗成人股骨干骨折中应用芯钻髓内钉系统辅助置入远端锁钉的体会  

Experience of distal locking assisted by Gustilo Revdrill Interlocking Nails System in adult femoral shaft fractures treated with interlocking intramedullary nail

作　　者：陈涛[1] 田智勇[1] 陈洪强[1] 戴科晶[1] 陈德斌[1] 叶赟 吴西智 蔡荣 吴德伟[1] CHEN Tao;TIAN Zhiyong;CHEN Hongqiang;DAI Kejing;CHEN Debin;YE Yun;WU Xizhi;CAI Rong;WU Dewei(The First Department of Orthopaedics,the Forth People′s Hospital of Guiyang,Guiyang 550000,China)

机构地区：[1]贵阳市第四人民医院(贵阳市骨科医院)骨一科,贵阳550000

出　　处：《实用医学杂志》2023年第7期886-893,共8页The Journal of Practical Medicine

摘　　要：目的探讨芯钻髓内钉系统在应用交锁髓内钉治疗成人股骨干骨折中辅助置入远端锁钉的特点及临床效果。方法回顾性分析贵阳市第四人民医院2020年7月至2022年7月收治的股骨干骨折患者,利用骨科下肢牵引床,平卧位,使用顺行交锁髓内钉治疗。按照置入远端锁钉方法的不同分为两组,其中芯钻髓内钉系统组20例,体外瞄准架髓内钉系统组20例。比较两组在置入远端锁钉时的首次成功率、透视次数及用时。结果芯钻髓内钉系统组置入远端锁钉首次锁定成功率高(95.0%vs.60.0%),透视次数少[(5.9±7.8)次vs.(22.5±4.7)次],操作时间短[(10.6±5.8)min vs.(17.3±2.0)min],差异有统计学意义(P<0.05)。芯钻髓内钉系统组软钻钻头断裂1例,经开槽后取出。两组中均未出现伤口感染病例,无内固定物断裂病例,所有病例骨折愈合趋势良好,患侧髋膝关节功能满意。结论芯钻髓内钉系统治疗成人股骨干骨折远端锁定准确率高,术中透视次数少,操作时间短,创伤小,临床效果好;但建议选择稍长的髓内钉,需严格按照操作手册仔细操作。Objective To investigate the characteristics and clinical effects of distal locking which assisted by Gustilo Revdrill Interlocking Nails System in adult femoral shaft fractures treated with interlocking intramedul⁃lary nail.Methods From July 2020 to July 2022,in the Fourth People′s Hospital of Guiyang,consecutive clinical data of 40 patients with femoral shaft fracture treated with intramedullary nail were assigned to study group and control group according to the method of the distal locking.Study group(n=20)was treated with Gustilo Revdrill Interlocking Nails System,and control group(n=20)was given in vitro targeting system.The first success rate of the distal locking,the frequency of fluoroscopy,and the time of distal locking were recorded and compared.Results The first success rate of the distal nailing rate was 95.0%in study group,significantly higher than the control group(60.0%)(P<0.05).The control group took significant greater frequency of radiographic exposure than the study group[(5.9±7.8)times vs.(22.5±4.7)times,P<0.001].The time of distal locking in study group were significantly reduced as compared with the control group[(10.6±5.8)min vs.(17.3±2.0)min,P<0.001].1 case of soft drill bent and broken was noted in the early study group,removed after slotting.There was no case of wound infection and internal fixation breakage in both groups;The trend of fracture healing was good in all cases;The function of the hip and knee joint were satisfactory.Conclusion Adult femoral shaft fracture treated with interlocking intramedullary nail which assisted by the Gustilo Revdrill Interlocking Nails System for distal lock⁃ing could improve the first success rate,decrease the frequency of fluoroscopy,short the time of operation of the distal locking,less trauma,and have a good clinical results.However,it is recommended to choose a slightly lon⁃ger intramedullary nail,and strictly following the operation manual.

关 键 词：芯钻髓内钉系统 远端锁定 交锁髓内钉 股骨干骨折 

分 类 号：R683.42[医药卫生—骨科学]