磁力导航逆行带锁髓内针远端锁钉技术治疗股骨骨折的应用

Application of magnetic navigation retrograde interlocking intramedullary nail distal locking technique in the treatment of femoral fracture

目的探讨磁力导航逆行带锁髓内针远端锁钉技术治疗股骨中下段骨折的临床疗效。方法 2017年1月~2019年2月收治的股骨中下段骨折病人38例,根据治疗方法不同分为两组,磁力导航锁定髓内针组(A组)16例,使用磁力导航系统进行髓内钉的远端锁定技术治疗;机械瞄准锁定髓内针组(B组)22例,使用机械瞄准方法进行髓内钉的远端锁定技术治疗,比较两组病人术中远端一次性锁定的成功率、手术时间、术中出血量、并发症发生率、骨折愈合率、骨折愈合时间、术后膝关节KOOS评分。结果 A组的远端锁定一次成功率高于B组,手术时间短于B组,术中出血量少于B组,并发症发生率低于B组,术后膝关节KOOS功能评分优良率高于B组,差异有统计学意义(P<0.05)。A组骨折愈合率高于B组,骨折愈合时间短于B组,但差异无统计学意义(P>0.05)。结论磁力导航逆行带锁髓内针远端锁钉技术治疗股骨中下段骨折锁定时间短,效率高,放射线暴露时间短。

Objective To investigate the clinical effect of magnetic navigation retrograde interlocking intramedullary nail distal locking technique in the treatment of middle and lower femoral fractures.Methods A retrospective analysis of the patients with mid-lower femoral fractures who were admitted to our hospital from January 2017 to February 2019 and were followed up were divided into two groups:navigation lock group(group A)and mechanical aiming lock group(Group B),16 patients in Group A using electromagnetic navigation distal locking technology,22 patients in Group B using mechanical targeting distal locking technology.The following indicators were compared in the two groups:the success rate of the intraoperative distal one-time locking in the two groups,operation time,intraoperative blood loss,complication rate,fracture healing rate,fracture healing time,postoperative knee KOOS score.Results The success rate of distal locking once in group A was higher than that of group B,the operation time was shorter than that of group B,the intraoperative blood loss was less than that of group B,the incidence of complications was lower than that of group B,and Knee function postoperative score was better than that of group B,the difference was statistically significant(P<0.05).The fracture healing rate in group A was higher than that in group B,and the fracture healing time was shorter than that in group B,but the difference was not statistically significant(P>0.05).Conclusion Magnetic navigation retrograde interlocking intramedullary nail distal locking technique for the treatment of mid-lower femoral fracture has the advantages of short locking time,high efficiency and short radiation exposure time.