闭合复位装置复位交锁髓内钉固定治疗股骨干骨折的临床疗效

Analysis of the Clinical Efficacy of Closed Reduction Device in Treating Femoral Shaft Fractures with Interlocking Intramedullary Nails

目的:探讨股骨干三维闭合复位装置复位交锁髓内钉固定治疗股骨干骨折的临床疗效。方法:2015年6月至2019年5月采用三维骨折复位装置闭合复位股骨干骨折交锁髓内钉固定38例,术中在骨折远端置入1枚Schanz螺钉,连接复位装置操控进行骨折复位,导针通过骨折远端后按常规交锁髓内钉固定操作。结果:38例患者均闭合复位成功并顺利置入交锁髓内钉,手术时间平均为92 min(60~150 min),术中X线透视时间平均为20.5 s(10~30 s),术中出血量平均为120.5 mL(50~150 mL),术中骨折闭合复位时间平均18 min(10~25 min)。35例骨折愈合(优33例,良2例);2例是近2个月手术,复查发现有明显骨痂;1例是术后1个月,仍在随访中。结论:三维骨折复位装置在股骨干骨折闭合复位中能有效复位骨折,操作简单,使用方便,并且医护人员能在骨折复位过程中离开手术间,减少透视的辐射。

Objective:To explore the clinical efficacy of the three-dimensional closed reduction device in treating femoral shaft fracture with internal fixation of interlocking intramedullary nail.Methods:38 patients with femoral shaft fractures underwent closed reduction and interlocking intramedullary nail fixation using a three-dimensional fracture reduction device from June 2015 to May 2019.During the operation,a Schanz screw was placed at the distal end of the fracture,and then a reduction device was connected to control the fracture reduction.The conventional interlocking intramedullary nail fixation operation was performed when the guide needle passed the distal end of the fracture.Results:All 38 patients were successfully reduced and inserted interlocking intramedullary nails.The average operation time was 92 min(60 to 150 min),and the average intraoperative X-ray fluoroscopy time was 20.5 s(10 to 30 s).The average intraoperative blood loss was 120.5 mL(50 to 150 mL),and the average fracture reduction time during operation was 18 min(10 to 25 min).Among all the cases,35 cases had fracture healing,33 cases were excellent,and 2 cases were good.2 cases underwent surgery 2 months ago and showed obvious bone callus at reexamination.1 case who underwent surgery 1 month ago was still under followed up.Conclusion:The three-dimensional fracture reduction device can effectively and easily perform closed reduction of femoral shaft fractures,and it can reduce the radiation of fluoroscopy during the fracture reduction process.