闭合复位经皮小切口交锁髓内针内固定治疗股骨干骨折

Minimally invasive percutaneous osteosynthesis with intramedullary nail and close reduction by manipulation for the treatment of femoral shaft fractures

目的：研究闭合复位经皮小切口交锁髓内针内固定治疗股骨干骨折的手法手术联合技术和临床疗效。方法：自2006年1月至2010年12月，96例纳入观察，男67例，女29例；年龄16～88岁，平均39岁。骨折根据AO分型：A型29例，B型46例，C型21例。采用正骨手法和经皮小切口植入技术进行治疗，并对骨折术后功能进行评价。结果：所有患者获随访，时间12～24个月，患者均达到骨性愈合，平均愈合时间4个月（3～10个月）.按Thorsen等股骨骨折术后形态评估系统评价：优87例，良7例，中2例，差0例。结论：充分运用髓内针的设计特点，结合闭合正骨手法复位，能在更小的创伤条件下完成股骨干骨折的治疗，疗效满意。

Objective： To explore the technique and clinical results of close reduction by manipulation and minimally invasive percutaneous osteosynthesis with intramedullary nail for the treatment of femur shaft fractures. Methods： A retrospective study was conducted to analyze 96 patients with the femur shaft fractures who had been treated with close reduction by manipulation and minimally invasive percutaneous osteosynthesis with intramedullary nail. There were 67 males and 29 females. The average age of patients was 39 years old（ranging from 16 to 88）. According to AO fracture classification for the femur shaft fractures,there were 29 cases of type A,46 type B,21 type C. Results： All the patients were followed up and the duration ranged from 12 to 24 months（averaged,15 months）. All the fractures showed union. The time required for the bony union ranged from 3 to 10 months（averaged,4 months）. The clinical results were evaluated by Thorsen classification system. At the latest follow-up,87 patients obtained excellent results,7 good,2 fair. Conclusion： This treatment method combines advantages of intramedullary nail with close manipulative reduction,so can get satisfactory clinical results for the treatment of femoral shaft fracture with minimal trauma.