逆行髓内钉与锁定钢板治疗股骨远端骨折的疗效分析

Curative effect analysis of retrograde intramedullary nail and locking plate in the treatment of distal femoral fractures

目的探讨与比较逆行髓内钉与锁定钢板对股骨远端骨折的临床治疗效果。方法收集本院2015年1月至7月入院的60例股骨远端骨折患者随机分为两组，逆行髓内钉组患者给予逆行髓内钉固定术，锁定钢板组患者给予锁定钢板固定，比较两组患者固定相关临床指标与膝关节功能治疗效果。结果逆行髓内钉组患者术中出血量（184．29±50．25）ml、手术时间（97．04±16．75）min、术中透视次数（13．02±3．55）次、内固定费用（5．23±2．46）千元与愈合时间（70．34±8．83）d，显著低于锁定钢板组[（244．47±75．89）ml，（117．85±18．97）min，（15．99±3．96）次，（16．42±5．02）千元，（75．92±9．58）d]，两组比较差异具有统计学意义（P〈0．01）；两组患者膝关节功能治疗优良率（90．00％VS．83．33％）比较差异无统计学意义（P〉0．05）。结论虽然两种内固定方式治疗膝关节功能均较为显著，但逆行髓内钉固定术治疗与愈合时间更短，术中创伤更小，费用更低，故而应优先选择，具有借鉴性。

Objective To investigate and compare the clinical effect of retrograde intramedullary nail and locking plate in the treatment of distal femoral fractures. Methods 60 cases of distal femoral fracture admitted in our hospital from January 2015 to July 2015 were selected, and randomly divided into two groups. Retrograde intramedullary nail group was treated with retrograde intramedullary nail fixation, while locking plate group was treated with locking plate fixation. Then compared fixation associated clinical indicators and the clinical effect of knee function of two groups. Results The blood loss in operation of retrograde intramedullary nail group was （184.29±50.25）ml, operation time was （97.04±16.75）min, fluoroscopy times in operation was （13.02±3.55） times, fixation cost was （5.23±2.46） thousand yuan, healing time was （70.34±8.83）d, significantly lower than （244.47±75.89）ml, （117.85±18.97）min, （15.99±3.96）times, （16.42±5.02）thousand yuan, （75.92±9.58）d of locking plate group, with statistically significant differences between two groups （P〈0.01）; there was no statistically significant difference in knee function treatment excellent rate between two groups （90% vs.83.33%; P〉0.05）. Conclusions Although two internal fixation treatment of knee function were significant, the treatment and healing time of retrograde intramedullary nail fixation were shorter, less trauma surgery, lower costs. So, this surgical approach should be preferred, with significance.