股骨重建钉治疗股骨干合并同侧髋部骨折的临床应用分析

Clinical Analysis of the Treatment of Ipsilateral Hip and Femoral Shaft Fractures by Reconstruction Interlocking Nail

目的评价股骨重建钉治疗股骨干合并同侧髋部骨折的临床疗效。方法回顾性分析2008年6月—2011年12月就诊于该院的70例股骨干合并同侧髋部骨折患者的临床资料,其中采用股骨重建钉进行内固定治疗的35例为观察组,采用常规髓内钉加钢板固定治疗的35例为对照组,对所有患者进行3年的随访,根据患者的术后恢复情况及随访情况评价临床疗效。结果观察组患者治疗后用Friedman-Wyman系统评价结果中优82.9%,明显高于对照组的68.6%,两组差异有统计学意义(P<0.05);观察组患者治疗后髋部骨折愈合、股骨干骨折愈合情况明显优于对照组患者,两组差异有统计学意义(P<0.05);观察组患者在围手术期并发症发生率明显小于对照组患者,两组比较差异有统计学意义(P<0.05)。结论股骨重建钉对股骨干合并同侧髋部骨折进行内固定有较好的固定效果,可同时对两个受伤部位进行固定,减少了因固定而造成的损伤,相比较于常规的髓内钉联合钢板固定治疗具有更好的临床效果,对于治疗股骨干合并同侧髋部骨折具有更加好的临床效果。

Objective To evaluate the clinical effect of reconstruction interlocking nail in the treatment of ipsilateral hip and femoral shaft fractures. Methods The clinical data of 70 patients with ipsilateral hip and femoral shaft fractures admitted to our hospital during June 2008 and December 2011 was selected as the research object. 35 patients who underwent treatment with reconstruction interlocking nail and 3 years follow-up were assigned to the observation group, while the other 30 patients who were treated with conventional intramedullary nailing and plate fixation and underwent 3 years follow-up were assigned to the control group. The clinical effects of the two groups were evaluated according to the recovery and follow-up. Results Friedman-Wyman evaluation showed that after treatment 82.9% of the patients in the observation groups were in Class A, obviously higher than 68.6%in the control group（P〈0.05）; the healing condition of hip fracture and femoral shaft fractures in the observation group was superior to that of the control group, and the difference was statistically significant（P〈0.05）; the perioperative complication rate was lower in the observation group than in the control group, and the difference was statistically significant（P〈0.05）. Conclusion Compared with conventional intramedullary nailing and plate fixation, reconstruction interlocking nail has better clinical effect in the treat-ment of ipsilateral hip and femoral shaft fractures because it can reduce the injure caused by internal fixation through the synchronous processing for fractures in two sites.