下肢骨折髓内固定术治疗对下肢骨折患者并发症的影响

The Impact to apply intramedullary fixation of lower extremity fracture for lower limb fracture patient's complication

目的探讨下肢骨折髓内固定术治疗对下肢骨折患者并发症的影响。方法回顾性分析本院2012年1月至2018年12月收治的200例下肢骨折并采用手术治疗患者的临床资料,按照不同固定方式分为髓内钉组(n=124)和钢板螺钉组(n=76),术中采用闭合、有限切开和切开复位。观察下肢骨折髓内固定术治疗对患者并发症的影响。结果术中输血:髓内钉组4例,钢板螺钉组20例;术后感染:髓内钉组2例,钢板螺钉组4例;固定失效及骨不连:髓内钉组2例,钢板螺钉组5例;下肢深静脉血栓形成:髓内钉组1例,钢板螺钉组6例。结论髓内钉治疗下肢骨折较钢板螺钉固定手术创伤小、出血少,感染率低,固定牢固,早期可进行关节功能锻炼,且可减少下肢深静脉血栓形成。

Objective To investigate the effect of intramedullary fixation on the complications of lower extremity fracture.Methods A retrospective analysis of 200 patients of clinical data with lower extremity long stem bone fractures treated with surgical treatment was performed in our hospital from January 2012 to December 2018.According to different fixation methods,the patients were divided into the intramedullary nailing group(n=124)and the plate and screw group(n=76).Closed,limited incision and open reduction were used intraoperatively.To observe the effect of intramedullary fixation on the complications of lower extremity fracture.Results Intraoperative blood transfusion:4 cases in intramedullary screw group,20 cases in plate screw group.Postoperative infection:2 cases in the intramedullary nail group,4 cases in plate screw group;Fixation failure and bone nonunion:2 cases in intramedullary nail group,5 cases in plate screw group.Deep venous thrombosis of lower limbs:1 case in intramedullary nail group and 6 cases in plate screw group.Conclusion The treatment of lower extremity fracture with intramedullary nailing is less traumatic,less bleeding,less chance of infection,and fixed firmly than that with plate and screw fixation.Early joint function exercise can be performed,and deep venous thrombosis of lower extremity can be reduced.