旋入髓内钉与交锁髓内钉治疗成人股骨干骨折疗效分析

Clinical study on rotative-type interlocking intramedullary nailing and intramedullary interlocking nail in treatment of fracture of adult femur

[目的]评价旋入式自锁髓内钉、交锁髓内钉在治疗成人股骨干骨折的临床疗效。[方法]自2005年6月~2010年6月采用旋入式自锁髓内钉、交锁髓内钉治疗成人股骨干骨折53例,男38例,女15例,年龄21~65岁;53例患者中交锁髓内钉固定治疗28例,旋入式自锁钉固定治疗25例,对两组分别就其平均手术时间、骨折平均愈合时间、HSS knee rating score法评定功能的各项指标进行比较分析。[结果]53例均获随访,随访时间6~24个月,平均10个月。交锁髓内钉固定组断钉1例,伤口浅表感染1例,骨延迟愈合3例;旋入式自锁钉固定组骨折延迟愈合1例,骨折短缩移位1例。交锁髓内钉固定组的平均手术时间为（95±10）min,旋入式自锁钉固定组平均（55±10）min。交锁髓内钉固定组骨折平均愈合时间为（22.0±3.5）周;旋入式自锁髓内钉固定组平均骨折愈合时间为（20.0±2.5）周;HSS knee rating score法评定功能恢复优良率：交锁髓内钉固定组（88.5±3.0）%;旋入式自锁髓内钉固定组（92.5±3.60）%。旋入式自锁髓内钉固定组与交锁髓内钉固定组相比,统计学有显著性意义（P〈0.05）。[结论]旋入式自锁髓内钉结构简单,操作方便快捷,创伤小,疗效可靠,是治疗成人股骨干骨折的有效方法。

[Objective]To analyze the clinic effect of rotative-type interlocking intramedullary nail and intramedullary interlocking nail in treatment of femoral fracture.[Method]From June 2005 to June 2010,53 cases（38 males and 15 females,21 to 65 years old） of femural fractures were treated by the rotative type interlocking intramedullary nail and intramedullary interlocking nail.Twenty-eight fractures in 53 patients were fixed with interlocking nails,25 cases by revolving self-locking nail.The two groups were evaluated with the average operation time,the healing time,HSS knee rating score.[Result] The patients were followed up for 6-24 months.In the interlocking group,there were one breakage of the screws,one superficial infection and the other 3 delayed bone healing.In the revolving self-locking nail group,there were found one delayed bone healing and one short dislocation.The average operation time was（95±10） minutes in the interlocking group,（55±10） minutes in the revolving self-locking nail group.The healing time of interlocking group was（22.0±3.5） weeks,the revolving self-locking nail group was（20.0±3.6） weeks.the excellent rate of function recovery of interlocking group was（88.5±3.0）% by HSS knee rating score,the revolving self-locking nail group was（92.5±3.60）%.The excellent to good rate in revolving self-locking nail group was significantly greater than in the interlocking group（P0.05）.[Conclusion]The rotative type interlocking intramedullary nail is an effective method to treat adult femur fracture because of its simple structure,easy and good operation,less invasive and reliable therapeutic effects.