不同类型髓内钉治疗成人股骨干骨折的比较研究

Comparative study on different types of intramedullary nail in the treatment of femoral shaft fracture

目的比较不同类型髓内钉治疗成人股骨干骨折的临床效果。方法选择我院收治的104例股骨干骨折患者,总结其临床资料,采用旋入式自锁髓内钉治疗的54例为观察组,采用交锁髓内钉治疗的50例为对照组,观察记录2组患者的疗效、康复时间、膝关节韧带损伤评估(HSS)结果及并发症情况,进行组间比较。结果观察组的治疗优良率为96%,略高于对照组的92%,组间差异无统计学意义(P>0.05);观察组的手术时间、住院时间、骨性愈合时间明显短于对照组(P<0.05),术中出血量明显少于对照组(P<0.05);观察组与对照组治疗后HSS评分均较治疗前显著提高(P<0.05),但观察组HSS评分提高更显著(P<0.05);观察组的并发症发生率为4%,对照组为8%,组间差异无统计学意义(P>0.05)。结论旋入式自锁髓内钉治疗成人股骨干骨折创伤小,康复快,疗效肯定,并且能够有效促进膝关节功能恢复,是安全有效的治疗方案。

Objective To compare the clinical results of different types of intramedullary nail in the treatment of femoral shaft fracture.Methods The clinical data of 104 cases of patients with femoral shaft fracture in our hospital were summarized,54 cases treated by self-locking spinning insertion nail as the observation group,50 cases treated by interlocking intramedullary nail as the control group.The efficacy,recovery time,knee ligament damage assessment（HSS）results and complications of two groups were observed and recorded.Results The excellent rate of observation group was 96%,slightly higher than 92% of the control group,there was no significant difference（P〈0.05）;the operative time,hospital stay,bone healing time of observation group were significantly shorter than the control group（P〈0.05）,and the blood loss of observation group was significantly less than the control group（P〈0.05）;the HSS score of both groups were significantly improved after surgery compared with before surgery（P〈0.05）,but the observation group showed improvement after surgery（P〈0.05）;the complication rate of observation group and the control group was 4%,and 8%,respectively.There was no significant difference（P〈0.05）.Conclusion Self-locking spinning insertion nail in the treatment of femoral shaft fracture has little trauma,faster recovery,more effectiveness,and it is conducive to the recovery of ankle mobility and safety.It is a safe and effective treatment option.