小切口复位交锁髓内钉固定治疗股骨干骨折

Treatment for Femoral Shaft Fracture with Interlocking Intramedullary Nail Combined Minimal Invasive Incision

目的探讨小切口复位交锁髓内钉固定治疗股骨干骨折的手术治疗经验和临床疗效。方法 选择2008年6月～2010年6月本院收治的股骨干骨折33例(治疗组),所有患者术前均经临床及X线确诊,患者均接受小切口复位交锁髓内钉固定;另将同期实施闭合复位交锁髓内钉固定的29例股骨干骨折患者作为对照组。并对两组患者治的疗效果进行比较。结果治疗组患者均顺利完成小切口复位交锁髓内钉固定手术,对照组有6例中转小切口复位。治疗组平均手术时间(80.87±5.43)min,平均出血量为(150.76±20.38)mL,与对照组相比,差异有统计学意义(均P<0.01)。两组患者均获随访,随访时间12～18个月,所有患者均获得骨性愈合,无感染、断钉、膝关节僵直、骨不连、脂肪栓塞等严重并发症出现。治疗组骨折愈合优25例,占75.76%,良8例,占24.24%,与对照组相比无统计学差异(均P>0.05)。结论小切口复位交锁髓内钉固定治疗股骨干骨折具有骨折复位好、创伤小、手术时间短、固定可靠、骨折愈合快、功能恢复快等优点,且无严重并发症,适于基层医院推广应用。

Objective To investigate the surgical experience and clinical efficacy of treatment for femoral shaft fracture with interlocking intramedul/ary nail combined minimal invasive incision. Methods 33 patients （study group） who stayed in our hospital were selected from June 2008 to June 2010. All patients were diagnosed of femoral shaft fracture by clinic and X-ray and underwent surgery of interlocking intramedullar-y nail combined minimal invasive incision. In ~ddition,29 cases who underwent surgery of interlocking intramedullary nail combined closed reduction at the same time were set up in our study （Control group）. Results The surgeries of interlocking intramedullary nail combined minimal invasive incision in Study group were performed successfully. The average operative time was （80.87 ± 5.43）min.,and the average intraoperative blood loss was （150.76 ± 20.38）mL. Compared with control group, there was significant difference （respectively P〈0.01）. Follow-up of 12- 18 months showed that all patients achieved clinical bone healing. No complications of infection ,break of nail,stiffen knee joint,nonunion and fat embolism syndrome occurred in our study. The excellent rate of fracture healing in study group was 75.76% and the good rate was 24.24%. There was not significant difference between two groups （respectively P〉0.05）. Conclusion The treatment for femoral shaft fracture with interlocking intramedullary nail combined minimal invasive incision has the advantage of confirmed effectiveness of fracture reduction,minimal invasion,less operative time,confirmed immobilization,rapid recovery of fracture Healing and functional rehabilitation,no serious complication. The procedure should be the best choice of treatment for femoral shaft fracture.