成人股骨干中上段骨折治疗方法的临床分析

Treatment of middle-upper part of femoral shaft fracture in adult

目的 探讨成人股骨干中上段骨折治疗的临床效果。方法 对 82例成人股骨干中上段骨折 ,分别采用以下 5种方法进行治疗 ,其中牵引配合小夹板 1 5例 ,外固定支架 1 5例 ,AO加压钢板 1 2例 ,梅花钉 2 5例 ,带锁髓内钉 1 5例。并进行临床随访分析。结果 随访半年以上 ,82例骨折全部愈合。按 Hohl评分标准 ,膝关节功能优良率分别为 :牵引配合小夹板 80 %、外固定支架 73.3%、AO加压钢板 1 0 0 %、梅花钉 1 0 0 %、带锁髓内钉 1 0 0 %。结论 股骨干骨折的治疗 ,应根据骨折部位、类型、患者的全身情况选择治疗方法。 (1 )牵引小夹板外固定的方法仍有一定的应用价值。 (2 )不建议常规使用单侧多功能外固定支架治疗股骨骨折。 (3)对大多数股骨干骨折来说 ,若能正确地使用接骨板 。

Objective To study the efficacy of treatment on fracture of middle upper part of femoral shaft.Methods Of 82 cases of middle upper part of femoral shaft fracture,traction combined with splint external fixation were used in 15 cases,external fixation in 15 cases,AO steel plate internal fixation in 12 cases,Kuntscher nail in 25 cases and intramedullary interlocking nail 15 cases.The follow up time lasted for 6～24 months.Results Eighty two patients had the fracture united.According to Hohl's standard of joint function,excellent or good results were 80%,73.3%,100%,100%,100% in above groups respectively.Conclusion The methods of treatment for fracture of middle upper part of femoral shaft in adults must be chosen according to the location and type of fractures,the status of patients,the conditions of their own local hospital,and the degree of the mastery of new technology.We do not advocate the view of using external fixation as a rule.The results of treatment for fracture of middle upper part of femoral shaft in adults are refquently very good if you could use AO compression plate accurately.