闭合复位髓内钉内固定治疗股骨干粉碎性骨折的效果

Effect of Closed Reduction and Intramedullary Nail Internal Fixation in the Treatment of Comminuted Femoral Shaft Fracture

目的分析闭合复位髓内钉内固定治疗股骨干粉碎性骨折(CFFS)患者的效果。方法选取濮阳市人民医院2017年3月至2019年3月收治的CFFS患者83例,依照手术方式分为两组。两组均接受髓内钉内固定治疗,对照组(41例)采用切开复位方式,观察组(42例)采用闭合复位方式,比较两组手术优良率、围手术期情况(术中失血量、手术及术后骨折愈合时间)、膝关节功能Lysholm评分、膝关节活动度和并发症发生率。结果观察组手术优良率(92.50%)较对照组(75.00%)高(P<0.05);与对照组对比,观察组术后骨折愈合时间较短,术中失血量较少(P<0.05),两组手术时间差异无统计学意义(P>0.05);术后6、12个月,两组膝关节功能、膝关节活动度均得到改善,且观察组膝关节功能Lysholm评分较对照组高,膝关节活动度较对照组大(P<0.05);观察组并发症发生率(2.50%)较对照组(20.00%)低(P<0.05)。结论闭合复位髓内钉内固定治疗CFFS效果较好,能有效减少患者术中失血量,缩短术后骨折愈合时间,改善膝关节功能,扩大膝关节活动度,且并发症少。

Objective To analyze the effect of closed reduction and intramedullary nail internal fixation in the treatment of femoral shaft comminuted fracture(CFFS).Methods A total of 83 CFFS patients from March 2017 to March 2019 in Puyang People’s Hospital were selected and divided into different groups according to the surgical methods.The control group(41 cases)received open reduction and the observation group(42 cases)received closed reduction.The operative excellent rate,perioperative conditions(intraoperative blood loss,operative and postoperative fracture healing time),Lysholm score of knee function,knee motion and complications were compared between the two groups.Results The excellent and good rate of the observation group was higher than that of the control group(92.5%vs.75.0%,P<0.05).Compared with the control group,the observation group had shorter postoperative fracture healing time and less intraoperative blood loss(P<0.05),while there was no statistical difference in the operative time between the two groups(P>0.05).Six and twelve months after operation,knee function and range of motion of both groups improved,Lysholm score of knee function of observation group was higher than that of control group,and range of motion of knee was greater than that of control group(P<0.05).The incidence of complications in the observation group was lower than that in the control group(2.50%vs.20.00%,P<0.05).Conclusion The closed reduction and internal fixation of intramedullary nails in the treatment of CFFS has better treatment effect,which can effectively reduce the intraoperative blood loss,shorten the postoperative fracture healing time,improve the function of the knee joint,expand the range of motion of the knee joint,and have fewer complications.