摘要
目的 ：探讨采用亚洲型股骨髓内钉微创治疗股骨干多段粉碎骨折的中期随访疗效。方法 ：自2011年6月至2012年10月,采用牵引床下微创复位、亚洲型股骨髓内钉固定治疗16例股骨干多段粉碎骨折患者,其中男10例,女6例;年龄21~49岁,平均34.5岁;受伤至手术时间3~24 d,平均9.1 d。根据AO分型：C1型6例,C2型2例,C3型8例。分别于术后3、6、12个月行股骨全段X线片检查评价骨折愈合情况,并采用Harris髋关节评分和HSS膝关节评分评价术后功能。结果：16例患者均获得随访,时间24~36个月,平均28.4个月。手术时间88~112 min,平均90.7 min;术中出血量150~200 ml,平均188.75 ml;骨折愈合时间5~9个月,平均5.4个月。所有患者伤口甲级愈合,无内固定松动、断裂、骨折移位等并发症发生。术后3、6、12个月髋关节Harris评分比较差异无统计学意义（F=0.07,P=0.893〉0.05）,其中优10例,良5例,可1例。膝关节HSS评分比较差异无统计学意义（F=0.08,P=0.876〉0.05）,其中优9例,良6例,差1例。结论 ：亚洲型股骨髓内钉治疗股骨干多段粉碎骨折可借助多种微创方式置入,创伤小,术后恢复快,中期随访效果满意。16例患者的研究样本量较小,远期临床效果仍需进一步观察。
Objective：To investigate midterm follow-up results on Asian femoral intramedullary nail in treating segmental and eomminuted femoral fractures. Methods：Between June 2011 and October 2012,16 patients with segmental and eomminuted femoral fractures were treated with minimally invasive reset and Asian femoral intramedullary nail under extension table. Among them ,there were 10 males and 6 females aged from 21 to 49 years old with an average of 34.5 years old ; the time from injury to operation ranged from 3 to 24 d with an average of 9.1 d. There were 6 cases were type C 1,2 cases were type C2 and 8 cases were type C3 according to AO classification. X-ray of femoral segment at 3,6 and 12 months after operation were applied for evaluating fracture healing. Harris score of hip joint and HSS score of knee joint were used to evaluate postoperative function. Results：All patients were followed up from 24 to 36 months with an average of 28.4 months. Operative time was from 88 to 112 min with an average of 90.7 min; blood loss ranged from 150 to 200 ml with an average of 188.75 ml ;the time of fracture healing was from 5 to 9 months with an average of 5.4 months. All incision were healed at stage I. No loosening, breakage of internal fixation and displacement of fracture were occurred. There were no significant differences in Harris score of hip joint at 3 ,6 and 12 months after operation（F=0.07 ,P=0.893〉0.05）, 10 cases obtained excellent results ,5 good and 1 moderate. There was no obvious meaning in HSS score of knee joint （F=0.08 ,P=-0.876〉0.05 ） ,9 cases obtained excellent results, 6 good and 1 poor. Conclusion：Asian femoral intramedullary nail could treat segmental and comminuted femoral fractures by using variety of less invasive ways ,which has advantages of less trauma, quick recovery of function and satisfied midterm following-up results. But long term following-up effects remains to be seen.
出处
《中国骨伤》
CAS
2016年第6期522-525,共4页
China Journal of Orthopaedics and Traumatology
关键词
股骨骨折
骨折
粉碎性
骨折固定术
髓内
外科手术
微创性
Femoral fracture
Fractures, eomminuted
Fracture fixation,intramedullary
Surgical procedure, minimally invasive
