交锁髓内钉固定术与脂肪栓塞综合征

Interlocking intramedullary nailing and fat embolism syndrome

目的 探讨交锁髓内钉手术方式 (扩髓与不扩髓操作、固定部位、开放与闭合复位方式 )与脂肪栓塞综合征的关系。方法 2 12例交锁髓内钉手术分别按扩髓与不扩髓操作、手术部位(股骨或胫骨 )、开放与闭合复位方式分组 ,比较各观察因素与脂肪栓塞综合征的关系。结果 扩髓与不扩髓操作脂肪栓塞综合征的发生差异有显著性 (P <0 .0 5 ) ;手术部位、开放与闭合复位对脂肪栓塞的发生无显著性影响 (P >0 .0 5 )。结论 交锁髓内钉手术时扩髓操作能显著增加脂肪栓塞综合征发生的机会 ,而手术部位 (胫骨或股骨 )、复位方式 (开放与闭合 )对脂肪栓塞的发生没有显著影响。

ObjectiveTo study the relationship between fat embolism syndrome and interlocking intramedullary nailing operation including reamed or undreamed,fixation site,mode of reduction.Methods212 patients subject to interlocking intramedullary nailing operations were divided into groups in terms of reamed or unreamed,femoral fracture or tibial fracture,reduction by operation or non-operation.The causes for fat embolism syndrome were observed.ResultsThere was significant difference in the occurrence of fat embolism syndrome between the unreamed and reamed nailing(P< 0.05), but fracture site (femoral or tibial) and modes of reduction had no significant effect on the occurrence of fat embolism syndrome.ConclusionUnreamed interlocking intramedullary nailing can protect the patient from fat embolism syndrome,but the fracture sites (femoral or tibial)and modes of reduction have no significant effect to fat embolism syndrome.