交锁髓内钉与锁定钢板治疗股骨干骨折的临床疗效分析

Analysis of clinical effects by interlocking intramedullary nail and locking plate in the treatment of femoral shaft fracture

目的探讨交锁髓内钉与锁定钢板内固定治疗股骨干骨折的疗效。方法 59例因股骨干骨折接受手术治疗并获得随访患者,依据内固定方式分为交锁髓内钉组(INF组,28例)和锁定钢板组(LCP组,31例),比较两组患者临床相关指标、并发症发生率及末次随访Karlstrom-Olerud股骨骨折疗效评分。结果 INF组手术时间、术中出血量及总失血量低于LCP组(P<0.05),术中透视次数多于LCP组(P<0.05);所有患者均获得骨性愈合,INF组愈合时间(14.6±3.2)周,LCP组为(18.2±3.5)周,两组比较差异有统计学意义(P<0.05);INF组、LCP组术后疗效评价优良率分别为96.4%及90.3%,两组比较差异无统计学意义(P>0.05)。结论交锁髓内钉与锁定钢板治疗股骨干骨折均能获得良好临床疗效,与锁定钢板相比交锁髓内钉内固定具有手术时间短、失血少、术后骨折愈合快等优点,因而交锁髓内钉更利于治疗股骨干骨折,可在临床进一步应用。

Objective To investigate curative effects by interlocking intramedullary nail and locking plate in the treatment of femoral shaft fracture. Methods A total of 59 femoral shaft fracture patients, who receiving surgical treatment and follow-up, were divided by their internal fixation ways into interlocking intramedullary nail group （INF group, 28 cases） and locking plate group （LCP group, 31 cases）. Related clinical indexes, incidences of complications and Karlstrom-Olernd femoral fracture efficacy scores at the last follow-up were compared between the two groups. Results INF group and lower operation time, intraoperative bleeding volume and total bleeding volume than LCP group （P〈0.05）, and it had more intraoperative fluoroscopy time than LCP group （P〈0.05）. All patients had bony union, and the healing time was （14.6 ± 3.2）weeks in INF group, and （18.2 ± 3.5） weeks in LCP group. The difference had statistical significance between the two groups （P〈0.05）. The good rate of postoperative effect was 96.4% and 90.3% in INF group and LCP group, and their difference had no statistical significance （P〉0.05）. Conclusion Interlocking intramedullary nail and locking plate can provide good clinical effect in treating femoral shaft fracture. Comparing with locking plate, interlocking intramedullary nail contains advantages of short operation time, few bleeding volume, and quick postoperative healing. Therefore,. interlocking intramedullary nail is more feasible in treating femoral shaft fracture. It is worthy of further clinical application.