交锁髓内钉与锁定加压钢板内固定治疗股骨干骨折临床疗效观察
|
摘要
目的探讨股骨干骨折采用交锁髓内钉与锁定加压钢板内固定治疗对其疗效的影响。方法选择本院2015年8月至2017年9月收治的股骨干骨折患者92例,将所有患者按抽签法分为对照组和观察组各46例。对照组采用锁定加压钢板内固定治疗,观察组采用交锁髓内钉治疗,术后随访20个月,比较两组手术相关指标、生活质量评分、膝关节功能、并发症发生率。结果观察组术中出血量(103.28±13.24)mL、骨折愈合时间(19.33±2.51)周、手术时间(79.65±14.22)min、住院时间(10.71±2.25)d,并发症发生率17.39%均较对照组[(156.32±12.41)mL、(22.21±3.01)周、(87.36±13.47)min、(14.32±2.32)d、4.35%]低,躯体功能(26.57±3.03)分、心理健康(27.24±3.62)分、社会功能(28.34±4.01)分、角色状态(28.36±3.74)分、膝关节优良率95.65%均较对照组[(20.35±2.41)分、(20.16±3.11)分、(21.32±3.37)分、(21.25±4.03)分、80.43%]高,差异有统计学意义(P<0.05)。结论相较于锁定加压钢板内固定,股骨干骨折采用交锁髓内钉治疗,可减轻机体创伤性,降低并发症发生率,促进膝关节功能恢复,改善患者生活质量。
Objective To investigate the efficacy of interlocking intramedullary nail and locking compression plate internal fixation in treatment of femoral shaft fracture.Methods A total of 92 patients with femoral shaft fracture in the hospital from August 2015 to September 2017 were divided into two groups by draw lots,with 46 cases in each group.Control group was given locking compression plate internal fixation,while observation group was treated with interlocking intramedullary nail.After 20-month postoperative follow-up,the surgical indexes,living quality,knee joint function,incidence of complications were compared between the two groups.Results The intraoperative bleeding volume,fracture healing time,operation time,hospital stays,incidence of complications in observation group[(103.28±13.24)mL,(19.33±2.51)weeks,(79.65±14.22)min,(10.71±2.25)d,17.39%]were lower than those of control group [(156.32±12.41)mL,(22.21±3.01)weeks,(87.36±13.47)min,(14.32±2.32)d,4.35%],the scores of physical function,mental health,social function,role emotional,excellent rate of knee joint in observation group[(26.57±3.03)points,(27.24±3.62)points,(28.34±4.01)points,(28.36±3.74)points,95.65%]were higher than those of control group[(20.35±2.41)points,(20.16±3.11)points,(21.32±3.37)points,(21.25±4.03)points,80.43%](P<0.05).Conclusion Compared with locking compression plate internal fixation,interlocking intramedullary nail in treatment of femoral shaft fracture can reduce trauma,decrease the incidence of complications,promote recovery of knee joint function,improve living quality.
Objective To investigate the efficacy of interlocking intramedullary nail and locking compression plate internal fixation in treatment of femoral shaft fracture.Methods A total of 92 patients with femoral shaft fracture in the hospital from August 2015 to September 2017 were divided into two groups by draw lots,with 46 cases in each group.Control group was given locking compression plate internal fixation,while observation group was treated with interlocking intramedullary nail.After 20-month postoperative follow-up,the surgical indexes,living quality,knee joint function,incidence of complications were compared between the two groups.Results The intraoperative bleeding volume,fracture healing time,operation time,hospital stays,incidence of complications in observation group[(103.28±13.24)mL,(19.33±2.51)weeks,(79.65±14.22)min,(10.71±2.25)d,17.39%]were lower than those of control group [(156.32±12.41)mL,(22.21±3.01)weeks,(87.36±13.47)min,(14.32±2.32)d,4.35%],the scores of physical function,mental health,social function,role emotional,excellent rate of knee joint in observation group[(26.57±3.03)points,(27.24±3.62)points,(28.34±4.01)points,(28.36±3.74)points,95.65%]were higher than those of control group[(20.35±2.41)points,(20.16±3.11)points,(21.32±3.37)points,(21.25±4.03)points,80.43%](P<0.05).Conclusion Compared with locking compression plate internal fixation,interlocking intramedullary nail in treatment of femoral shaft fracture can reduce trauma,decrease the incidence of complications,promote recovery of knee joint function,improve living quality.
引文
[1]张耀,胡林,谢增如.微创钢板与交锁髓内钉内固定治疗成人股骨干骨折的疗效分析[J].中国骨与关节损伤杂志,2015,30(8):797-800.
[2]黄玉成,焦竞,程文俊,等.交锁髓内钉结合锁定板治疗股骨干骨折钢板内固定术后非感染性骨不连[J].中华实验外科杂志,2017,34(8):1411-1413.
[3]王臣,肖万军.成年人股骨干骨折双钢板锁定内固定治疗的疗效分析[J].中国医科大学学报,2017,46(10):924-926.
[4]简争光,崔巍,徐志钢,等.大粗隆入路小切口治疗股骨干骨折疗效分析[J].中国矫形外科杂志,2015,23(24):2303-2304.
[5]史海山.闭合复位股骨干骨折髓内钉与解剖钢板置入内固定:骨折稳定性比较[J].中国组织工程研究,2015,19(17):2724-2729.
[6]戴锦章,陈长青,毛思,等.钢板加异体骨板固定治疗股骨干骨折髓内钉固定术后骨折不愈合[J].中国骨伤,2015,28(2):174-176.
[7]闫军,周劲松,李雷,等.闭合复位加长型股骨近端防旋髓内钉内固定治疗股骨干骨折合并同侧股骨粗隆间骨折[J].中国微创外科杂志,2015,21(2):163-166.
[8]朱明喜.闭合复位与切开复位交锁髓内钉内固定术治疗股骨干骨折的比较研究[J].现代中西医结合杂志,2016,25(22):2451-2453.
[9]付备刚,王秀会,蔡攀,等.闭合复位与切开复位交锁髓内钉内固定治疗股骨干骨折的疗效比较[J].中国骨与关节损伤杂志,2015,30(2):151-154.
[10]张占山,刘长城,邢文钊,等.不同类型髓内钉治疗成人股骨干骨折的比较研究[J].山西医药杂志,2015,44(3):251-253.
[11]黄必军,顾宇彤.闭合复位髓内钉内固定与中药热敷结合治疗股骨干骨折疗效观察[J].四川中医,2016,34(10):140-142.
[12]阿布力米提·阿木提,张谢卓,徐超,等.带锁髓内钉与髓外钢板修复股骨干骨折的Meta分析[J].中国组织工程研究,2016,20(17):2575-2584.
[13]石勇,洪泽亚,陈子建,等.不同内固定方式对股骨干骨折术后行动能力的影响[J].中国骨与关节损伤杂志,2017,32(8):847-849.
[14]刘伟,杨帆,栾和旭,等.钢板与髓内钉固定治疗闭合复位股骨干骨折的疗效及随访[J].山西医药杂志,2017,46(6):703-706.
[15]陈劲,钟华,肖刚,等.两种内固定方法治疗股骨干骨折的疗效比较[J].临床骨科杂志,2015,18(6):720-721.
[2]黄玉成,焦竞,程文俊,等.交锁髓内钉结合锁定板治疗股骨干骨折钢板内固定术后非感染性骨不连[J].中华实验外科杂志,2017,34(8):1411-1413.
[3]王臣,肖万军.成年人股骨干骨折双钢板锁定内固定治疗的疗效分析[J].中国医科大学学报,2017,46(10):924-926.
[4]简争光,崔巍,徐志钢,等.大粗隆入路小切口治疗股骨干骨折疗效分析[J].中国矫形外科杂志,2015,23(24):2303-2304.
[5]史海山.闭合复位股骨干骨折髓内钉与解剖钢板置入内固定:骨折稳定性比较[J].中国组织工程研究,2015,19(17):2724-2729.
[6]戴锦章,陈长青,毛思,等.钢板加异体骨板固定治疗股骨干骨折髓内钉固定术后骨折不愈合[J].中国骨伤,2015,28(2):174-176.
[7]闫军,周劲松,李雷,等.闭合复位加长型股骨近端防旋髓内钉内固定治疗股骨干骨折合并同侧股骨粗隆间骨折[J].中国微创外科杂志,2015,21(2):163-166.
[8]朱明喜.闭合复位与切开复位交锁髓内钉内固定术治疗股骨干骨折的比较研究[J].现代中西医结合杂志,2016,25(22):2451-2453.
[9]付备刚,王秀会,蔡攀,等.闭合复位与切开复位交锁髓内钉内固定治疗股骨干骨折的疗效比较[J].中国骨与关节损伤杂志,2015,30(2):151-154.
[10]张占山,刘长城,邢文钊,等.不同类型髓内钉治疗成人股骨干骨折的比较研究[J].山西医药杂志,2015,44(3):251-253.
[11]黄必军,顾宇彤.闭合复位髓内钉内固定与中药热敷结合治疗股骨干骨折疗效观察[J].四川中医,2016,34(10):140-142.
[12]阿布力米提·阿木提,张谢卓,徐超,等.带锁髓内钉与髓外钢板修复股骨干骨折的Meta分析[J].中国组织工程研究,2016,20(17):2575-2584.
[13]石勇,洪泽亚,陈子建,等.不同内固定方式对股骨干骨折术后行动能力的影响[J].中国骨与关节损伤杂志,2017,32(8):847-849.
[14]刘伟,杨帆,栾和旭,等.钢板与髓内钉固定治疗闭合复位股骨干骨折的疗效及随访[J].山西医药杂志,2017,46(6):703-706.
[15]陈劲,钟华,肖刚,等.两种内固定方法治疗股骨干骨折的疗效比较[J].临床骨科杂志,2015,18(6):720-721.