国产交锁髓内钉治疗新鲜股骨干骨折的临床研究

Clinical research on fresh femoral shaft fracture treated by domestic interlocking intramedullary nail

目的探讨应用国产交锁髓内钉治疗新鲜股骨干骨折的临床效果。方法股骨干骨折38例,34例采用小切口复位,4例采用闭合复位的方法,顺行插入交锁髓内钉固定。结果 38例患者术后5～12个月(平均8.6个月)随访,骨折愈合时间为10～15周(平均12.6周)。35例患者髋关节活动恢复正常,3例患者出现髋关节外展功能稍受限(<80%),1例股骨短缩约1 cm。根据疼痛程度、活动范围、步行能力、日常生活,采用JOA评分为优21例,良13例,可4例,优良率89.0%。结论国产交锁髓内钉内固定治疗新鲜股骨干骨折能有效地维持骨折段稳定性,小切口辅助复位,具有手术创伤小、手术时间缩短、骨折局部血运破坏小、感染率低、骨折愈合率高等优点,是治疗股骨干骨折较好的方法。

Objective To explore the clinical effect of fresh femoral shaft fracture treated by domestic interlocking intramedullary nail. Methods In 38 patients with fresh femoral shaft fracture. 34 patients were restorated in small incision, 4 patients received closed restoration and the intramedullary nails were inserted along the line. Results Thirty-eight patients were followed up for 5 - 12 months （ average 8. 6 months） after operation. The time of fracture healing were 10 - 15 weeks （average 12. 6 weeks）. In 35 patients hip activity return to normal, in 3 patients hip abduction function was restricted slightly （ 〈 80% ）, and in 1 patient with femur shortened about 1 cm. According to the level of pain, range of movement, walking ability, daily life, and using JOA score ： excellent effect was found in 21 patients, good in 13 patients, fair in 4 patients, the excellent and good rate was 89. 0%. Conclusion It can effectively maintain stability of fracture section of fresh femoral shaft fracture treated by domestic interlocking intramedullary nail, with auxiliary restoration in small incision, this method has advantages of small, shorter operation time, less damage to the local blood supply of fracture, lower infection rate, and higher fracture healing rate. It is a good method for treating femoral shaft fracture.