不同体位下牵引联合髓内钉固定对股骨干骨折治疗效果的影响  

Effect of traction in different postural positions combined with intramedullary nailing in the treatment of femoral shaft fractures

作　　者：韩冬 王薇姣 孙政文[3] 马玉鹏 巩金鹏 Han Dong;Wang Weijiao;Sun Zhengwen;Ma Yupeng;Gong Jinpeng(Department of Traumatology and Orthopaedics,Yantai Mountain Hospital,Yantai 264000,China;Department of Otolaryngology,Head and Neck Surgery,Yantai Mountain Hospital,Yantai 264000,China;Department of Trauma I,Yantai Mountain Hospital,Yantai 264000,China)

机构地区：[1]烟台市烟台山医院创伤骨科,烟台264000 [2]烟台市烟台山医院耳鼻喉头颈外科,烟台264000 [3]烟台市烟台山医院创伤一科,烟台264000

出　　处：《中华生物医学工程杂志》2023年第5期560-564,共5页Chinese Journal of Biomedical Engineering

摘　　要：探究不同体位下牵引联合髓内钉固定对股骨干骨折治疗效果的影响。回顾性分析在我院创伤骨科诊治的76例股骨干骨折患者根据不同体位分为观察组和对照组,比较两组围手术期指标、术后临床指标、影像学评估结果。研究发现两组术后并发症比较,差异无统计学意义(P>0.05);观察组手术时间、术中出血量、术中透视次数、体位摆放时间均少于对照组,差异有统计学意义(P<0.05);观察组术后负重时间短于对照组,且观察组术后3个月膝关节活动度(ROM)和Harris功能评分高于对照组,差异有统计学意义(P<0.05);两组骨折复位优良率比较,差异无统计学意义(P>0.05);观察组骨折愈合时间早于对照组,差异有统计学意义(P<0.05)。侧卧位髓内钉固定对股骨干骨折患者可有效缩短手术时间、体位摆放时间、术后负重时间、骨折愈合时间,减少术中出血量及术中透视次数,改善膝关节功能和髋关节功能,安全性较高。To explore the effect of traction in different postural positions combined with intramedullary nailing in the treatment of femoral shaft fractures,76 patients with femoral shaft fracture diagnosed and treated in our hospital were retrospectively analyzed.Patients were classified into observation group and control group according to different postural positions,and clinical effectiveness was evaluated via perioperative indicators,postoperative clinical indicators and imaging assessment results.Comparison found no statistical difference in the complications between two groups(P>0.05),while observation group had shorter operation time,less intraoperative blood loss,fewer intraoperative fluoroscopy times and shorter posture placement time than those of control group,with statistical difference(P<0.05).The postoperative weight-bearing time was shorter in observation group than in control group,and observation group scored higher on Range of Motion(ROM)and Harris Hip Score(HHS)than control group at postoperative 3 months(P<0.05).The excellent rate of fracture reduction demonstrated no statistical difference between two groups(P>0.05),while observation group had decreased time to fracture healing than control group,with statistical difference(P<0.05).In conclusion,intramedullary nail fixation of femoral shaft fractures in lateral positions can effectively shorten shorten the time of operation,posture placement,postoperative weight-bearing and fracture healing,reduce the amount of intraoperative blood loss and frequency of intraoperative fluoroscopy,improve the function of knee joint and hip joint,and and has a good safety profile.

关 键 词：髓内钉 股骨 膝关节 不同体位 牵引 

分 类 号：R687.3[医药卫生—骨科学]