股骨髓内钉芯钻瞄准系统与体外瞄准架系统的远端锁定效果比较

Comparison of core drilling intramedullary nail vs. in vitro targeting system for distal locking of femoral shaft fractures

目的比较股骨髓内钉芯钻瞄准系统与体外瞄准架系统在治疗股骨干骨折远端锁定过程中的应用效果。方法选取我院2015年8月至2017年8月连续收治的98例拟行髓内钉固定术治疗闭合股骨干骨折的病人,按随机数字表法分为研究组和对照组,每组49例。研究组病人采用芯钻瞄准系统进行股骨髓内钉远端锁钉操作,对照组病人应用体外瞄准架系统进行远端锁钉操作。比较分析两组病人的术中远端锁钉首次锁定成功率、远端锁定透视次数、远端锁定完成时间和术中出血量。结果研究组与对照组远端锁钉首次锁定成功率分别为93.9%和49.0%,研究组成功率明显高于对照组,差异有统计学意义(P<0.05)。研究组远端锁定透视次数、远端锁定完成时间、术中出血量[(3.2±0.5)次、(7.3±1.1)min、(220.7±10.5)ml]均少于对照组[(12.2±2.4)次、(15.2±3.6)min、(350.3±33.7)ml],差异均有统计学意义(P均<0.05)。结论采用芯钻瞄准系统进行远端锁钉的置入可以有效提高远端锁钉的锁定成功率、减少手术创伤及降低医患术中放射线暴露量。

Objective To compare the effect of core drilling intramedullary nail vs.in vitro targeting system for distal locking of femoral shaft fractures.Methods From August 2015 to August 2017,consecutive clinical data of 98 patients with closed femoral shaft fracture treated with intramedullary nail were divided into study group and control group according to the random number table method.Study group(49 cases) was treated with core drilling intramedullary nail system,and control group(49 cases) was given the in vitro targeting system.The first success rate of the distal locking,the frequency of perspective,the time of distal locking,and the blood loss were recorded and compared.Results The first success rate of the distal nail rate was 93.9% in study group,significantly higher than in the control group(49%)(P<0.05).The frequency of perspective,time of distal locking and blood loss in study group[3.2±0.5,(7.3±1.1) min,(220.7±10.5) ml]were significantly reduced as compared with the control group[12.2±2.4,(15.2±3.6) min,(350.3±33.7) ml](P<0.05).Conclusion Femoral shaft fracture treated with core drilling intramedullary nail for distal locking can improve the first success rate of the distal locking,reduce surgical trauma,and significantly decrease the frequency of perspective.