带锁髓内钉与锁定加压钢板治疗股骨干骨折的疗效比较

Effect comparison of interlocking intramedullary nails and locking compression plates in treating femoral shaft fracture

目的比较带锁髓内钉与锁定加压钢板治疗股骨干骨折的临床效果。方法将84例股骨干骨折患者随机分为观察组(采用带锁髓内钉内固定,42例)和对照组(采用锁定加压钢板内固定,42例)。记录两组手术相关指标,比较两组术后恢复情况及并发症发生情况。结果患者均获得1年随访。术中出血量和术后引流量观察组明显少于对照组,差异均有统计学意义(P <0. 001)。手术时间及骨折愈合时间观察组明显短于对照组,差异均有统计学意义(P <0. 001)。骨折愈合优良率观察组为97. 62%,明显高于对照组的83. 33%(P <0. 05)。术后1年膝关节功能活动优良率观察组为95. 24%,明显高于对照组的78. 57%(P <0. 05);术后并发症发生率观察组为2. 38%,低于对照组的11. 90%,但两组比较差异无统计学意义(P> 0. 05)。结论带锁髓内钉内固定治疗股骨干骨折疗效肯定,与锁定加压钢板内固定相比,术中出血量较少,手术时间较短,更利于术后骨折愈合。

Objective To compare the efficacy of interlocking intramedullary nails and locking compression plate in the treatment of femoral shaft fractures.Methods The 84 cases of femoral shaft fractures were randomly divided into observation group(interlocking intramedullary nail internal fixation,42 cases)and control group(locking compression plate internal fixation,42 cases).Postoperative recovery and complications were recorded.Results All the patients were followed up for 1 year.The intraoperative blood loss and postoperative drainage volume were significantly lower in the observation group than those in the control group,and the differences were statistically significant(P<0.001).The operation time and fracture healing time were significantly shorter in the observation group than in the control group,and the differences were statistically significant(P<0.001).The excellent-good rate of postoperative fracture healing was 97.62%in the observation group,which was significantly higher than the 83.33%in the control group(P<0.05).The excellent-good rate of postoperative 1 year knee function was 95.24%in the observation group,which was significantly higher than the 78.57%in the control group(P<0.05).The incidence rate of postoperative complications was 2.38%in the observation group,which was lower than 11.90%in the control group,there was no significant difference between the two groups(P>0.05).Conclusions The effect of interlocking intramedullary nail for the treatment of femoral shaft fracture is affirmative,and compared with the locking compression plate fixation,the volume of intraoperative blood loss is less,the operation time is shorter,which is more conducive to the postoperative fracture healing.