逆行和顺行交锁髓内钉治疗股骨干骨折对比观察

发布时间：2018-04-10 11:03

  本文选题：股骨干骨折 + 逆行髓内钉　；参考：《安徽医科大学》2017年硕士论文

【摘要】：目的:在治疗股骨干中段骨折中,股骨髓内钉按照手术入路可分为顺行髓内钉和逆行髓内钉,我们设计这项临床研究旨在比较顺行髓内钉和逆行髓内钉在治疗股骨干中段骨折方面的异同,以利于在临床治疗中选择更加合理的术式,探讨髓内钉在临床上更好的应用。方法:2014年7月至2016年5月安徽医科大学第一附属医院共76例单侧闭合性股骨干中段骨折被纳入这项研究。所有患者的骨折均为急诊收治的新鲜骨折,其中被纳入顺行髓内钉治疗组(顺行钉组)40例,逆行髓内钉治疗组(逆行钉组)36例。所有患者均经至少6个月以上的随访,详细观察并记录两种术式手术情况(手术时间、失血量、有限切开例数)、骨折愈合情况(骨折愈合时间、愈合类型)及术后恢复情况(膝关节活动度、髋膝关节疼痛情况)。应用统计学方法对两组数据进行统计分析得出结论。结果:顺行钉组手术时间(125±8)min,逆行钉组手术时间(114±9)min,两组比较,P0.05,差异有统计学意义;顺行钉组骨折愈合时间(97±13)d,逆行钉组骨折愈合时间(98±13)d,两组比较,P0.05,差异无统计学意义;顺行钉组术后出现膝关节疼痛8例(20.0%),逆行钉组术后出现膝关节疼痛19例(52.8%),两组比较,P0.05;顺行钉组术后出现髋关节疼痛7例(17.5%),逆行钉组出现髋关节疼痛1例(2.7%),两组比较,P0.05;膝关节早期活动度逆行钉组显著少于顺行钉组,随着骨折愈合,两组并无显著差异。结论:两种手术方案治疗股骨干骨折均可取得良好的骨折愈合效果,但逆行钉治疗术后存在较多的膝关节疼痛的并发症。建议在其适应征内谨慎、综合选择。
[Abstract]:Objective: in the treatment of femoral shaft fractures, femoral intramedullary nail with surgical approach can be divided into antegrade intramedullary nail and retrograde intramedullary nail, we design this study aimed to compare the antegrade intramedullary nail and retrograde intramedullary nail, the similarities and differences in the treatment of femoral shaft fractures in the middle part, in order to facilitate the operation more reasonable in clinical treatment, to explore the application of better in clinical intramedullary nail. Methods: the First Affiliated Hospital of Medical University Of Anhui from July 2014 to May 2016 a total of 76 cases of unilateral closed femoral shaft fractures were included in this study. All patients with fractures were fresh fractures were treated in the emergency department, which is included in the treatment group antegrade intramedullary nailing (antegrade group) 40 cases, treatment group of retrograde intramedullary nail (retrograde nail group) 36 cases. All patients were treated with at least 6 months of follow-up, observed and recorded in detail two operative conditions (operative time, blood loss, have 闄愬垏寮，

本文编号：1730926