带锁髓内钉治疗四肢创伤骨折后骨不连临床观察

Clinical Observation of Interlocking Intramedullary Nail on Treatment of Bone Nonunion in Patients with Four-limb Fractures

目的探讨四肢创伤骨折后骨不连采用带锁髓内钉治疗的疗效。方法选取2014年4月~2015年4月期间我院接收的股骨干骨折后骨不连患者84例,随机分为对照组(给予动力加压钢板治疗,n=42)和观察组(给予带锁髓内钉治疗,n=42),观察两组疗效及相关指标。结果观察组术中输血量、术后引流量、手术时间、骨折愈合时间均显著低于对照组(P<0.05);治疗后,两组临床有效率、Lyshom评分和IKDC评分比较无明显差异(P>0.05);观察组固定后无断钉、感染、再骨折、关节僵硬病例,下肢深静脉血栓和愈合不良各1例,不良反应率为4.8%,并发症的发生率观察组为4.8%,对照组为9%,两组有差异(P<0.05)。结论四肢创伤骨折后骨不连采取带锁髓内钉治疗,疗效显著,且对患者创伤小,术后并发症发生率低,具有推广价值。

Objective： To investigate the effect of interlocking intxamedullary nail on treatment of bone nonunion in patients with four-limb fractures. Mettiods： Totally, 84 patients with bone nonunion after femoral shaft fractures were admitted and treated in our hospital from April 2014 to April 2015. They were randomly divided into control group and test group with 42 in each group. Patients in control group were treated with dynamic compression plate, while patients in test group were treated with interlocking intramedullary nail. The clinical effect was observed between two groups. Results： Duration of procedure, blood transfusion, amount of post-operation drainage, healing time in test group were significant better than those in control group （P〈0.05）. （2） After treatment, there were no significant differences in clinical efficient rate, Lyshom score, and IKDC score （P〉0.05）. （3） The rate of adverse reaction in test group （4.80%） was significantly lower than that in control group （9.00%） （P〈0.05）. Conclusions： Application of interlocking intramedullary nail on treatment of bone nonunion in patients with four-limb fractures has good results, little trauma and complications, worthy of popularizing.