股骨闭合复位器辅助复位股骨交锁髓内钉固定治疗股骨干骨折的临床疗效分析

发布时间：2018-01-04 13:32

本文关键词：股骨闭合复位器辅助复位股骨交锁髓内钉固定治疗股骨干骨折的临床疗效分析　出处：《苏州大学》2016年硕士论文　论文类型：学位论文

【摘要】：研究背景:股骨干骨折多因暴力引起,约占全身骨折的6%,传统的治疗方式有石膏托固定、外固定支架固定、内固定钢板固定及髓内钉固定,目前股骨髓内钉固定已成为股骨干骨折手术治疗的金标准。股骨干骨折端在肌肉的牵拉作用下,往往存在移位明显,采用单纯牵引架牵引闭合复位交锁髓内钉固定,虽能恢复下肢力线,但往往复位艰难、手术时间长、患者出血多、反复进针发生神经损伤、甚至出现术后髋关节外展无力、骨折端骨不连,影响患肢功能恢复。目的:探讨股骨闭合复位器辅助复位股骨髓内钉固定治疗股骨干骨折的临床疗效。为临床治疗股骨干骨折更好的理论及实际操作提供依据。方法:对100例股骨干骨折病例进行回顾性分析(其中50例行股骨闭合复位器辅助复位股骨交锁髓内钉固定,50例单纯牵引架牵引复位股骨髓内钉固定),两组病例在手术时间、出血量、导针反复进针次数、骨折愈合时间、需要骨折断端切开辅助复位例数、术后并发症发生率进行统计学分析。结果:50例行股骨闭合复位器辅助复位股骨交锁髓内钉固定术后随访12-18个月,骨折均愈合,愈合时间4-8个月,平均5.24个月。无感染发生,无内外翻畸形、短缩畸形发生。术后患者髋膝关节功能按Harris及HHS评定标准优良率达92%。50例单纯牵引架牵引复位股骨髓内钉固定患者术后随访12-18月,发生骨不连1例,余患者骨折均愈合,愈合时间平均5.36个月,无感染发生,无内外翻畸形、短缩畸形发生。术后患者髋膝关节功能按Harris及HHS评定标准优良率达88%。两组病例在手术时间、出血量、导针反复进针次数、需要骨折断端切开辅助复位例数上存在统计学差异,在骨折愈合时间、并发症发生率、髋膝关节功能优良率方面无明显统计学差异。结论:对于股骨干骨折,股骨闭合器辅助复位股骨交锁髓内钉固定是一种操作方便、创伤小、效果可靠的治疗手段。
[Abstract]:Background: femoral shaft fractures are mostly caused by violence, accounting for about 6 of the total body fractures. The traditional treatment methods include plaster fixation, external fixation, internal fixation plate fixation and intramedullary nail fixation. At present, femoral bone marrow nail fixation has become the gold standard for the surgical treatment of femoral shaft fracture. Simple traction frame traction closed reduction interlocking intramedullary nail fixation, although can restore the lower limb force line, but often difficult reduction, long operation time, the patient bleeding, recurrent needle nerve injury. There was even postoperative hip abduction weakness and nonunion at the end of the fracture. Effects on the functional recovery of affected limbs. Objective:. To explore the clinical effect of femoral closed reduction device assisted reduction femoral bone marrow nail fixation in the treatment of femoral shaft fracture, and to provide the basis for clinical treatment of femoral shaft fracture in theory and practice. A retrospective analysis of 100 cases of femoral shaft fracture was made. The femoral interlocking intramedullary nail was fixed with femoral closed reduction device in 50 cases. There were 50 cases of traction frame traction reduction and femoral bone marrow nail fixation. In the two groups, the operation time, the amount of blood loss, the number of times of needle reentry, the time of fracture healing, the need of open reduction at the broken end of fracture were needed. Results 50 cases were followed up 12 to 18 months after femoral interlocking intramedullary nail fixation with closed reduction device of femur. The healing time was 4-8 months (mean 5.24 months). The excellent and good rate of hip and knee joint function according to Harris and HHS was 920.50 cases of simple traction frame traction reduction and femoral bone marrow nail fixation were followed up 12-18 cases after operation. Month. Bone nonunion occurred in 1 case. The fracture healing time of the remaining patients was 5.36 months on average. There was no infection and no varus deformity. The excellent and good rate of hip and knee joint function according to Harris and HHS was 88%. The operation time, blood loss and the times of needle reentry were observed in the two groups. There was statistical difference in the number of cases of open reduction needed to break the end of fracture, but there was no significant difference in fracture healing time, incidence of complications and the excellent and good rate of hip and knee joint function. Conclusion: for femoral shaft fracture. Femoral closure assisted reduction with interlocking intramedullary nail is a convenient, less invasive and effective treatment.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R687.3

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