弹性髓内钉与钢板治疗青海地区儿童股骨干骨折的疗效分析

发布时间：2018-03-15 01:29

本文选题：弹性髓内钉　切入点：钢板　出处：《青海大学》2012年硕士论文　论文类型：学位论文

【摘要】：弹性髓内钉与钢板治疗青海地区儿童股骨干骨折的疗效分析目的：探讨弹性髓内钉与钢板固定技术在青海地区儿童股骨干骨折治疗中的临床疗效，为临床医师选择治疗方法提供参考。方法：选取青海大学附属医院2010年3月--2011年10月儿童股骨干骨折住院病例37例，根据治疗方法的不同分为两组：弹性髓内钉治疗组(A组)：19例,其中男13例，女6例，年龄4--12岁，平均年龄6岁；钢板治疗组（B组）：18例，其中男12例，女6例，年龄5--11岁，平均年龄6岁。随访评估患者住院时间、手术时间、手术切口、术中失血量、术后切口引流量、完全负重时间、骨折愈合时间得差别；并对两种手术治疗方法的常见并发症及疗效进行比较和分析。结果：两组病例住院时间、手术时间、手术切口长度、术中失血量、术后切口引流量、完全负重时间、骨折愈合时间比较：住院时间差异有统计学意义（P＜0.05），手术时间差异有统计学意义（P＜0.05），手术切口长度差异有统计学意义（P＜0.05），，术中失血量差异有统计学意义（P＜0.05），术后切口引流量差异有统计学意义（P＜0.05），完全负重时间差异有统计学意义（P＜0.05），骨折愈合时间差异有统计学意义（P＜0.05）；两组病例皮肤坏死、骨不连、关节僵硬等并发症均未发生，仅B组发生1例浅表软组织感染，4例肌肉轻度萎缩，2例骨折端成角畸形（8—13°）,A组发生1例肌肉轻度萎缩；两组病例各发生1例双下肢不等长，差异无统计学意义（P0.05）。A组：优良率94.73％，B组：优良率66.67％，两组优良率差异有统计学意义（P＜0.05），A组疗效明显优于B组。结论：弹性髓内钉与钢板治疗儿童股骨干骨折相比较,在常见并发症发生率及临床疗效比较上明显优于钢板，故在满足适应症且医疗环境及经济条件许可的情况下，弹性髓内钉可作为治疗儿童股骨干骨折首选的内固定材料。
[Abstract]:Analysis of the curative effect of elastic intramedullary nail and plate in the treatment of femoral shaft fracture in children in Qinghai Province objective: to explore the clinical effect of elastic intramedullary nail and plate fixation in the treatment of femoral shaft fracture in children in Qinghai area. To provide a reference for clinicians to choose treatment methods. Methods: 37 cases of femoral shaft fracture in children from March 2010 to October 2011 in the affiliated Hospital of Qinghai University were selected and divided into two groups according to the different treatment methods: group A was treated with elastic intramedullary nailing (group A, n = 19), including 13 males and 6 females. The mean age was 6 years old, the mean age was 6 years old, the average age was 6 years old, the mean age was 6 years, and the mean age was 6 years, 18 cases in group B, 12 males and 6 females, followed up to evaluate the duration of hospitalization, operative time, operative incision, blood loss during operation, and the average age of 6 years. The difference of incision drainage, total load time and fracture healing time was obtained, and the common complications and curative effect of the two surgical methods were compared and analyzed. Results: the duration of hospitalization, operation time, length of incision, blood loss during operation, postoperative drainage of incision, time of total load, and total weight bearing time were observed in the two groups. Comparison of fracture healing time: there were significant differences in hospitalization time (P < 0.05), operative time (P < 0.05), operative incision length (P < 0.05), blood loss during operation (P < 0.05), drainage of incision after operation (P < 0.05). The quantity difference was statistically significant (P < 0.05), the time of complete weight loading was significantly different (P < 0.05), the difference of fracture healing time was statistically significant (P < 0.05), the skin necrosis of the two groups was significant (P < 0.05), and the difference between the two groups was significant (P < 0.05). None of the complications, such as nonunion and joint stiffness, occurred. Only one case of superficial soft tissue infection occurred in group B, 4 cases suffered from mild muscular atrophy, 2 cases with fracture end angulation malformation occurred in group A, and 1 case occurred mild muscle atrophy in group A, 1 case in each group, and 1 case in lower extremity unequal in length, 2 cases in group A, 1 case in group A, 1 case in group A and 1 case in group A. There was no significant difference between the two groups (P < 0.05). Group A: the excellent and good rate was 94.730.The excellent and good rate was 66.67.The difference between the two groups was statistically significant (P < 0.05). The curative effect of group A was significantly better than that of group B. Conclusion: elastic intramedullary nail is superior to plate in the treatment of femoral shaft fracture in children. Elastic intramedullary nail can be used as the first choice for the treatment of femoral shaft fracture in children.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R726.8

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