Intramedullary nails have been widely used in treating femoral shaft fractures. However, end caps falling into soft tissue intraoperatively may cause trouble to surgeons, prolong operative time and increase radiation ...Intramedullary nails have been widely used in treating femoral shaft fractures. However, end caps falling into soft tissue intraoperatively may cause trouble to surgeons, prolong operative time and increase radiation exposure. Additionally, difficulties may be encountered when removing nails because of callus formation over the nail tip. We performed a prospective study to compare two types of nails in managing femoral shaft fractures. Methods Group I consisted of seventy-four patients with unilateral femoral shaft fractures treated with cannulated interlocking anatomical femoral intramedullary nails. Group II consisted of seventy-eight patients treated with cannulated interlocking anatomical femoral intramedullary nails with tail wires. The patients＇ ages, fracture severity, duration of operation, fluoroscopy time, blood loss and falls of end caps into soft tissue were recorded. Nails were removed after fracture healing. The duration of operation and blood loss during nail removal were recorded. Results There were no significant differences between groups with respect to age and fracture severity （P 〉0.05）. End caps fell into soft tissue 17 times in 15 cases in group I and 21 times in 16 cases in group I1. An average of seven minutes was spent recovering a lost cap in group I. In group II, all lost caps were recovered immediately. The duration of operation and fluoroscopy time in group II was significantly less than in group I （P 〈0.05）. Asymptomatic palpable nodules were detected in 4 cases in group I1. Nail removals were performed on 58 patients in group I and 69 patients in group I1. The duration of operation, blood loss and complications in group II were less than in group I （P〈0.05）. Conclusion Intramedullary nails with tail wires facilitate both fracture fixation and nail removal, which can be used to treat femoral shaft fractures with less radiation exposure, shorter surgical time and fewer complications.展开更多
目的:总结应用“打孔栽桩”技术解决股骨近端防旋髓内钉(Proximal femoral nail antirotation,PFNA)螺旋刀片取出滑丝时的临床效果。方法:回顾性分析2015年1月—2023年1月于定西市人民医院骨科行股骨粗隆间骨折PFNA内固定取出术258例患...目的:总结应用“打孔栽桩”技术解决股骨近端防旋髓内钉(Proximal femoral nail antirotation,PFNA)螺旋刀片取出滑丝时的临床效果。方法:回顾性分析2015年1月—2023年1月于定西市人民医院骨科行股骨粗隆间骨折PFNA内固定取出术258例患者临床资料,其中发生螺旋刀片滑丝采用“打孔栽桩”技术取出者35例,设为打孔组。选取以常规术式取出螺旋刀片滑丝者35例,设为常规组。比较两组手术时间、打磨时间、术中出血量等指标。结果:打孔组手术时间[(65.12±7.16)min]、打磨时间[(26.25±5.12)min]短于常规组[(115.51±16.09)min、(70.91±6.95)min],差异有统计学意义(t=-16.96,P<0.05;t=-30.56,P<0.05);术中出血量[(71.23±9.97)mL]少于对照组[(116.08±18.81)mL](t=-12.47,P<0.05);两组术中均无医源性骨折、血管及神经损伤发生。常规组术后切口感染2例,后经换药后愈合,4例患者存在伤口周围少量金属碎屑残留,两组术后X线片复查内固定物全部取出。结论:PFNA螺旋刀片尾端出现滑丝时可选择“打孔栽桩”技术取出,是一种方便、快捷、安全的取出方法。展开更多
文摘Intramedullary nails have been widely used in treating femoral shaft fractures. However, end caps falling into soft tissue intraoperatively may cause trouble to surgeons, prolong operative time and increase radiation exposure. Additionally, difficulties may be encountered when removing nails because of callus formation over the nail tip. We performed a prospective study to compare two types of nails in managing femoral shaft fractures. Methods Group I consisted of seventy-four patients with unilateral femoral shaft fractures treated with cannulated interlocking anatomical femoral intramedullary nails. Group II consisted of seventy-eight patients treated with cannulated interlocking anatomical femoral intramedullary nails with tail wires. The patients＇ ages, fracture severity, duration of operation, fluoroscopy time, blood loss and falls of end caps into soft tissue were recorded. Nails were removed after fracture healing. The duration of operation and blood loss during nail removal were recorded. Results There were no significant differences between groups with respect to age and fracture severity （P 〉0.05）. End caps fell into soft tissue 17 times in 15 cases in group I and 21 times in 16 cases in group I1. An average of seven minutes was spent recovering a lost cap in group I. In group II, all lost caps were recovered immediately. The duration of operation and fluoroscopy time in group II was significantly less than in group I （P 〈0.05）. Asymptomatic palpable nodules were detected in 4 cases in group I1. Nail removals were performed on 58 patients in group I and 69 patients in group I1. The duration of operation, blood loss and complications in group II were less than in group I （P〈0.05）. Conclusion Intramedullary nails with tail wires facilitate both fracture fixation and nail removal, which can be used to treat femoral shaft fractures with less radiation exposure, shorter surgical time and fewer complications.
文摘目的:总结应用“打孔栽桩”技术解决股骨近端防旋髓内钉(Proximal femoral nail antirotation,PFNA)螺旋刀片取出滑丝时的临床效果。方法:回顾性分析2015年1月—2023年1月于定西市人民医院骨科行股骨粗隆间骨折PFNA内固定取出术258例患者临床资料,其中发生螺旋刀片滑丝采用“打孔栽桩”技术取出者35例,设为打孔组。选取以常规术式取出螺旋刀片滑丝者35例,设为常规组。比较两组手术时间、打磨时间、术中出血量等指标。结果:打孔组手术时间[(65.12±7.16)min]、打磨时间[(26.25±5.12)min]短于常规组[(115.51±16.09)min、(70.91±6.95)min],差异有统计学意义(t=-16.96,P<0.05;t=-30.56,P<0.05);术中出血量[(71.23±9.97)mL]少于对照组[(116.08±18.81)mL](t=-12.47,P<0.05);两组术中均无医源性骨折、血管及神经损伤发生。常规组术后切口感染2例,后经换药后愈合,4例患者存在伤口周围少量金属碎屑残留,两组术后X线片复查内固定物全部取出。结论:PFNA螺旋刀片尾端出现滑丝时可选择“打孔栽桩”技术取出,是一种方便、快捷、安全的取出方法。
