交锁髓内钉固定治疗93例胫腓骨骨折患者的临床疗效分析研究

目的：探讨交锁髓内钉固定治疗胫腓骨骨折患者的临床疗效。方法：本文选择93例患者随机分为治疗组（n＝47）和对照组（n ＝46）。对照组采用动力加压钢板或锁定加压钢板治疗，治疗组采用交锁髓内钉固定术治疗。观察比较两组临床疗效、生活质量情况、并发症、住院时间和骨痂愈合时间。结果：治疗组临床优良率为82．98％，显著高于对照组65．22％（Z ＝－5．572，P ＝0．000）。治疗后，治疗组和对照组 SF-36评分与治疗前比较均显著升高（t ＝－6．932，P ＝0．000；t＝－2．430，P＝0．017），且治疗组 SF-36评分显著高于对照组（t ＝2．087，P＝0．040）。治疗组的住院时间和骨痂愈合时间均低于对照组（P ＜0．05）。治疗组不良反应为12．77％，显著低于对照组30．43％（χ^2＝9．536，P＝0．007）。结论：交锁髓内钉固定治疗胫腓骨骨折临床疗效显著，住院时间和骨痂愈合时间显著缩短，毒副反应轻，可以有效改善患者生活质量。

中西医结合治疗胫骨骨不连疗效分析

目的:探讨和总结髂骨植骨结合中药治疗胫骨骨折术后骨不连的可行性与临床意义。方法:采用交锁髓内钉内固定、髂骨块或条周围填塞植骨结合中医内服、外用治疗胫骨骨折术后骨不连18例。结果:术后8～24个月(平均15个月)均达到骨折良好愈合,术后患肢功能好。无术后严重感染,无其他并发症发生。结论:中西医结合加交锁髓内钉、髂骨植骨治疗胫骨骨折术后骨不连方法可行,临床疗效可靠。

Treatment of ipsilateral hip and femoral shaft fractures with reconstructive intramedullary interlocking nail

Objective: To evaluate the results of reconstructive intramedullary interlocking nail in the treatment of ipsilateral hip and femoral shaft fractures. Methods: From August 1997 to November 2001, 13 patients were treated with the reconstructive intramedullary interlocking nail. Nine patients were associated with ipsilateral femoral neck fractures, three with ipsilateral intertrochanteric fractures, and one with subtrochanteric fracture. Results: The follow up time was from 6 to 38 months with an average of 14 months. All the femoral shaft and hip fractures healed up well. There was no nonunion of the femoral neck, and only one varus malunion. No patient had avascular necrosis of the femoral head. The average healing time for femoral neck fracture was 4.6 months and for shaft fracture 5.8 months. The joint movement and other functions were fairly resumed. Conclusions: The reconstructive intramedullary interlocking nail, with less trauma, reliable fixation, and high rate of fracture healing, is an ideal method of choice in the treatment of ipsilateral hip and femoral shaft fractures.