微创钢板与交锁髓内钉内固定治疗成人股骨干骨折的疗效分析

Curative effect analysis of minimally invasive plate and locked intramedullary nail internal fixation techniques in treatment of adult femur shaft fractures

目的分析微创钢板内固定技术(MIPO)与闭合复位交锁髓内钉内固定治疗成人闭合性股骨干骨折疗效。方法回顾性分析自2012-01—2014-06诊治的44例成年闭合性股骨干骨折,分别采用MIPO技术(MIPO组,24例)和交锁髓内钉(髓内钉组,20例)内固定治疗。比较2组手术时间、术中出血量、住院时间、骨折愈合时间、并发症、功能恢复情况。结果 MIPO组1例切口延迟愈合,切口有渗出物,经细菌培养和药敏试验证实为表皮葡萄球菌感染,经换药并应用敏感抗生素抗治疗后痊愈出院。髓内钉组切口均一期愈合。2组均未发生深部感染。MIPO组获得(13.50±2.98)个月随访,髓内钉组获得(13.70±3.15)个月随访。2组手术时间、住院时间、骨折愈合时间比较,差异无统计学意义(P>0.05)。2组手术均不涉及髋、膝关节内组织,术后患肢功能均恢复良好。结论 MIPO技术与闭合复位交锁髓内钉内固定治疗成人闭合性股骨干骨折均可取得满意的疗效,采用MIPO技术可减少术中出血量。

Objective To evaluate and compare the outcome of minimally invasive plate osteosyndesis （MIPO） and locked intramedullary nail in treatment of adult closed femoral fractures. Methods From Jan. 2012 to Jun. 2014, 44 adult patients with closed femoral fractures were treated with MIPO（24 eases） and locked intramedullary nail（20 cases）. The clinical data of operation time, blood loss, hospital stay, fracture healing time, complications and functional recovery of the two groups of patients were statistically compared in our study. Results One case suffered superficial infection in MIPO group, confirmed by bacterial culture and drug susceptibility test for S. epidermis infection, and recovered after application of sensitive antibiotic treatment. Intramedullary nailing group had primary healing of incision. There was no deep infection in our study. MIPO group of patients were followed-up for （13.50±2.98）months, intramedullary nail group of patients were followed-up for （13.70±3.15）months. There was no statistical significance （P 〉0.05） in operation time, hospital stay and fracture healing time. Two surgical methods did not affect the joint function. Conclusion Both MIPO technology and locked intramedullary nail to treat adult closed femoral fractures can obtain satisfactory curative effect. The MIPO technology can reduce blood loss.