急诊与择期行髓内钉内固定术治疗股骨干骨折的疗效比较

目的比较急诊与择期行闭合复位髓内钉内固定术治疗股骨干骨折（A、B型）的临床疗效方法回顾性分析2013年5月至2016年5月90例行闭合复位髓内钉内固定术治疗股骨干骨折患者的临床资料根据手术时间分为急诊组（伤后24h内手术）45例，择期组（伤后2411后手术）45倒比较两组术后骨折愈合情况及术后1年髋、膝关节功能情况结果两组患者在性别、年龄、骨折类型、手术操作差异无统计学意义（P〉0.05）急诊组与择期组患者骨折达到临床愈合标准时间分别为（9.12±1.08）周、（11.93±1.37）周，两组差异有统计学意义（P〈0．05）；术后1年根据Hams评分标准对髋关节功能进行评定，急诊组优良率93．3%，择期组优良率75．56％，两组差异有统计学意义（P〈0．05），术后1年根据KSS膝关节评分标准，急诊组优良率95．56％，择期组优良率73．3%,两组比较差异有统计学意义（P〈0.05）结论对于闭合性股骨干骨折（A、B型）患者，急诊行髓内钉内固定术能够促进骨折愈合，恢复正常髋、膝关节功能，减少患者痛苦，值得临床推广应用。

Objective To compare the clinical efficacy of closed reduction and intramedullary nailing in the treatment of femoral shaft fractures （ A and B ） . Methods The clinical data of 90 cases of femoral shaft fractures treated by closed reduction and intrameduUary nailing from May 2013 to May 2016 were retrospectively analyzed. According to the operation time, the patients were divided into emergency group （ 45 cases after operation within 24h ） and 45 cases in selective group （ 24h after injury ） . Fracture healing and postoperative hip and knee function were compared between the two groups after 1 years. Results There was no significant difference in gender, age, fracture type and operative procedure between the two groups （ P〉0.05 ） . The standard time of fracture healing in the emergency group and the elective group was （ 9.12 ± 1.08 ） weeks and （ 11.93±1.37 ） weeks respectively. The difference between the two groups was statistically significant （ P〈0.05 ） . 1 years after the operation, the hip function was evaluated according to the Harris score standard. The excellent rate of the emergency group was 93.33%, the excellent rate of the elective group was 75.56%, and the two groups were different. Study significance （ P〈0.05 ） , 1 years postoperatively according to the KSS knee score standard, the excellent rate in the emergency group was 95.56%, the excellent rate of the elective group was 73.33%, and the difference of the two groups was statistically significant （ P〈0.05 ） . Conclusion Intramedullary nail internal fixation for patients with closed femoral shaft fracture （ A and B ） can promote fracture healing, restore normal hip and knee function, and reduce the pain of patients. It is worthy of clinical application.