不同方法治疗股骨干骨折的效果比较

The Comparison of Various Treatments for Curing Femoral Shaft Fracture

目的评价不同方法治疗不同类型股骨干骨折的优缺点。方法187例股骨干骨折患者，男113例，女74例，年龄3，79岁，平均3l岁。根据不同情况分别采用骨牵引32例，皮牵引9例，加压钢板内固定71例，外固定支架治疗38例．及交锁髓内钉固定治疗53例。结果所有患者均获得随访，随访时间6—30个月（平均14．2个月），骨折均获得骨性愈合，平均愈合时间3．4个月。膝关节功能优93例，良48例，优良率88．9％。其中发生浅表感染13例，深部感染1例，内固定失败2例，延迟愈合（6个月）4例。经过相应处理均获得愈合。结论牵引、加压钢板内固定、外固定支架和交锁髓内钉治疗股骨干骨折分别有其不同的适应症和优缺点；根据骨折情况选用不同方法进行治疗才能达到最佳治疗效果；相比而言交锁髓内钉较钢板和外固定支架更适合于治疗股骨干骨折，而对于软组织损伤和污染较重的骨折，用外固定支架治疗更为安全。

Objective To compare several kinds of techniques for curing femoral shaft fracture. Methods 187 cases of femoral shaft fractures were treated with traction, open reduction and internal fixation with plate and screw, external fixation, and interlocking intramedullary nail. Results 187 cases were followed up from 6 months to 30 months, averaging 14.2 months. An patients with fractures were healed. 93 cases were excellent and 48 cases were good in the knee function （88.9 % ）. Of all cases, 13 cases with superfieial infection, 1 case with deep infection, 2 cases with plate broken and 4 cases with delay union were found. Conclusion Best curing outcoming would be obtained with different methods in accordance with different kinds of femoral shaft fracture.