加压交锁钉与静力交锁钉治疗下肢长骨骨折的比较研究

Comparison of Therapeutic Effect Between Self-compression Locking Nail and Static Locking Nail in Treatment Fracture of Femur and Tibia

目的比较加压交锁钉与静力交锁钉治疗下肢长骨骨折的临床疗效。方法对126例共131肢股骨、胫骨干骨折进行手术治疗,采用加压交锁钉固定41例43肢,静力交锁钉固定85例88肢,对两组分别就其生物力学、手术并发症、疗效以及手术适应证的各项指标进行对比分析。结果两组随访时间8个月以上,加压交锁钉组平均手术时间110 min,术后并发症发生率7%,骨折平均愈合时间17周,功能恢复优良率100%。静力交锁钉组平均手术时间90 min,术后并发症发生率22.7%,骨折平均愈合时间20周,功能恢复优良率96%。两组术后并发症统计学比较,有显著性差异(P<0.05)。结论两种锁钉疗效相同,但加压锁钉组术后并发症少,骨愈合快,适合稳定性、非缺损性粉碎骨折,在抗短缩方面不及静力锁钉组;对非稳定性骨折、断端缺损性粉碎骨折,宜选择静力交锁钉方式。

Objective To compare the therapeutic effect of self- compression nail and static locking nail in treatment of fracture of femur and tibia. Methods One hundred and thirty- one fractures of femur and tibia in 126 patients were included. Forty- three fractures in 41 patients were fixed with compression locking nail while 88 fractures in 85 patients were fixed by static locking nail. The two groups were compared for their biomechanical stability, operative procedures, postoperative complications, curative effect and indications. Results The patients were followed up for more than 8 months. In the compression locking nail group, the operation lasted for averaged 110 minutes; the mean fracture healing time was 17 weeks. The complications occurred in 7 % patients. The excellent rate of function recovery was 100 %. In the static locking nail group, the mean operative time and fracture healing time were 90 minutes and 20 weeks respectively. The complications occurred in 22.7% patients. The excellent rate was 96 %. There was significant difference in the post- operative complications between the two groups. Conclusion The compression locking causes fewer complications, which should be used in the stable fractures without defects. The static locking nail is suitable for the unstable comminuted fractures with fractures with bone defects.