侧卧位闭合复位交锁髓内钉治疗股骨干骨折疗效观察

Effect observation on closed Intramedullary of the Lateral Position in the treatment of Femoral shaft fractures

目的：探讨侧卧位闭合复位交锁髓内钉治疗股骨干骨折的疗效。方法：闭合复位侧卧位髓内钉治疗股骨干骨折34例（36侧），男19例，女15例，根据 AO 分型：A 型12例，B 型18例，C 型6例。记录患者手术时间、出血量、术后并发症及骨折愈合时间。结果：所有患者均顺利完成手术，手术时间45~120 min，出血量80~500 ml，随访时间4~24个月，2例出现延迟愈合，其余均正常骨性愈合，未出现内固定失效、断钉、退钉等并发症，未出现下肢不等长及旋转畸形。结论：侧卧位闭合复位髓内钉治疗股骨干骨折，手术视野开阔，手术时间短，无需骨科牵引床等设备，是一种可供选择的手术方式。

Objective To Evaluate the clinical outcomes of Closed intramedullary of the lateral position in the treatment of femoral shaft fractures. Method 34 cases（36 sides）of femoral shaft fractures were treated with closed reduction and internal fixation using interlocking intramedullary nails in the lateral position. There were 19 men and 15 women,and 12 cases of type A,18 cases of type B and 6 cases of type C by the AO classification. The mean operative time,intraoperative blood loss,postoperative compications and fracture healing time were recorded. Results All the surgeries were performed successfully. The operative time was 45 ~ 120 min,and the intraoperative blood was 80 ~ 500 ml,Follow - up of 4 ~ 24 months showed that all patient achieved clinical bone healing except two patients delayed healing. No complications ccurred after operation include break and exit of nail,nonunion. No leg Length discrepancy and rotational malreductions were observed in the patients. Conclusion In the intramedullary nailing of femoral shaft fractures,closed reduction at lateral position is a good alternative because it has advantages of less blood loss,shorter operation time,fewer complications and unnecessary requirement of a traction table.