交锁髓内钉与锁定加压钢板内固定治疗股骨干骨折临床疗效观察

Clinical efficacy of interlocking intramedullary nail and locking compression plate internal fixation in treatment of femoral shaft fracture

目的探讨股骨干骨折采用交锁髓内钉与锁定加压钢板内固定治疗对其疗效的影响。方法选择本院2015年8月至2017年9月收治的股骨干骨折患者92例,将所有患者按抽签法分为对照组和观察组各46例。对照组采用锁定加压钢板内固定治疗,观察组采用交锁髓内钉治疗,术后随访20个月,比较两组手术相关指标、生活质量评分、膝关节功能、并发症发生率。结果观察组术中出血量(103.28±13.24)mL、骨折愈合时间(19.33±2.51)周、手术时间(79.65±14.22)min、住院时间(10.71±2.25)d,并发症发生率17.39%均较对照组[(156.32±12.41)mL、(22.21±3.01)周、(87.36±13.47)min、(14.32±2.32)d、4.35%]低,躯体功能(26.57±3.03)分、心理健康(27.24±3.62)分、社会功能(28.34±4.01)分、角色状态(28.36±3.74)分、膝关节优良率95.65%均较对照组[(20.35±2.41)分、(20.16±3.11)分、(21.32±3.37)分、(21.25±4.03)分、80.43%]高,差异有统计学意义(P<0.05)。结论相较于锁定加压钢板内固定,股骨干骨折采用交锁髓内钉治疗,可减轻机体创伤性,降低并发症发生率,促进膝关节功能恢复,改善患者生活质量。

Objective To investigate the efficacy of interlocking intramedullary nail and locking compression plate internal fixation in treatment of femoral shaft fracture.Methods A total of 92 patients with femoral shaft fracture in the hospital from August 2015 to September 2017 were divided into two groups by draw lots,with 46 cases in each group.Control group was given locking compression plate internal fixation,while observation group was treated with interlocking intramedullary nail.After 20-month postoperative follow-up,the surgical indexes,living quality,knee joint function,incidence of complications were compared between the two groups.Results The intraoperative bleeding volume,fracture healing time,operation time,hospital stays,incidence of complications in observation group[(103.28±13.24)mL,(19.33±2.51)weeks,(79.65±14.22)min,(10.71±2.25)d,17.39%]were lower than those of control group[(156.32±12.41)mL,(22.21±3.01)weeks,(87.36±13.47)min,(14.32±2.32)d,4.35%],the scores of physical function,mental health,social function,role emotional,excellent rate of knee joint in observation group[(26.57±3.03)points,(27.24±3.62)points,(28.34±4.01)points,(28.36±3.74)points,95.65%]were higher than those of control group[(20.35±2.41)points,(20.16±3.11)points,(21.32±3.37)points,(21.25±4.03)points,80.43%](P<0.05).Conclusion Compared with locking compression plate internal fixation,interlocking intramedullary nail in treatment of femoral shaft fracture can reduce trauma,decrease the incidence of complications,promote recovery of knee joint function,improve living quality.