三种内固定在股骨干骨折中的应用

Clinical application of three internal fixation devices to treat fractures of femural shaft

目的观察股骨干骨折三种内固定的疗效。方法股骨干骨折,以外侧入路,分别予交锁髓内钉、梅花钉、加压钢板螺钉内固定。结果随访6～144个月,术后畸形愈合、延迟愈合及不愈合率:交锁髓内钉组3.1%、梅花钉组6.0%、加压钢板螺钉组10.6%;内固定失效率:交锁髓内钉组0%、梅花钉组4.5%、加压钢板螺钉组17.0%;术后患肢关节功能优良率:交锁髓内钉组81.3%、梅花钉组70.1%、加压钢板螺钉组59.6%。结论交锁钉治疗股骨干骨折近远期疗效满意,梅花钉次之,加压钢板螺钉最差。

Objective To study the value of three internal fixation devices (interlocking intramedullary nail, cloverleaf type intramedullary nail ,compression plate) in treatment of fractures of femural shaft. Methods All the patients were divided into three groups randomly. 32 patients were treated with the interlocking intramedullary nail , 67 patients with the cloverleaf type intramedullary nail, and 47 patients with the compression plate. Results After the three internal fixation devices were used in the fractures of femural shaft. All the patients were followed up for 6 months to 144 months. The total rates of postoperative deformity healing and delayed healing and nonunion were 3.1%, 6.0%and 10.6%respectively. The rates of the internal fixation failure were 0%, 4.5%and 17.0%respectively. The rates of excellent function recovery of lower limbs were 81.3%, 70.1%and 59.6%. Conclusions The data show that the curative effects of the interlocking intramedullary nail is better than those of the cloverleat type intramedullary nail and the plate in treatment to fracture of femural shaft.