轴向控制动力性带锁髓内钉与交锁髓内钉治疗下肢长管状骨骨折的比较

Efficacy of Axial Controlled Dynamic Intramedullary Nail in the Treatment of Lower Extremity Long Bone Fractures

目的观察轴向控制动力性带锁髓内钉与交锁髓内钉置入治疗下肢长管骨骨折的临床疗效差异。方法对68例股骨干骨折进行手术治疗,其中:38例采用交锁髓内钉固定,30例采用轴向控制动力性锁钉固定;对56例胫骨骨折进行手术治疗,其中:32例采用交锁髓内钉固定,24例采用轴向控制动力性锁钉固定。随访6～10个月,观察治疗结果。结果股骨干交锁髓钉组的平均手术时间是125 min,平均骨愈合时间是16周,交锁髓内钉优良率84.21%;股骨干轴向控制动力性锁钉组的平均手术时间是96 min,骨愈合时间是13周,优良率为93.33%;胫骨交锁钉组的平均手术时间是98 min,平均骨愈合时间是22周,交锁髓内钉优良率84.38%;胫骨轴向控制动力性锁钉组的平均手术时间是63 min,骨愈合时间是18周,优良率为95.83%。统计学分析,两组轴向控制动力性锁钉固定组在平均手术时间、愈合时间和优良率方面,与交锁髓内钉组比较差异均有显著性。结论轴向控制动力性锁钉较传统的交锁钉手术时间短、愈合时间快、功能恢复更理想,值得临床推广应用。

Objective To evaluate the effect of axial controlled dynamic intramedullary nail （ACDIN） in the treatment of lower extremity long bone fractures. Methods 68 patients with femoral shaft fracture were received opera- tion. 38 cases were treated with interlocking intramedullary nailing（ IIN）, 30 cases were ＇：reated with ACDIN. 56 patients with pilon fracture were received operation, 32 cases were treated with IIN, 24 eases were treated with ACDIN. The patients were followed up for 6 - 10 months. Results In patients with femoral shaft fracture under- went IIN, the mean operation time was 125 minutes, mean fracture healing time was 16 weeks, the excellent rate was 84. 21%, While in ACDIN group, they were 96 minutes, 13 weeks and 93.33%. In patients with pilon frac- ture, operation time was 98 minutes, mean fracture healing time was 22 weeks, the excellent rate was 84.38% in INN group, and 63 minutes, 18 weeks and 95.83% in ACDIN group. The difference was significant. Conclusion Axial controlled dynamic intramedullary nail is effective in the treatment of lower extremity long bone fractures.