摘要
背景:股骨髓内钉远端锁钉的精准快速置入仍是骨科医生面临的棘手问题,普通髓内钉远端锁定准确率低,耗时长且辐射高。目的:探讨应用芯钻远端锁定系统在髓内钉治疗成人股骨干骨折中的特点及疗效。方法:回顾性分析安徽医科大学第三附属医院2014年1月至2016年12月收治使用顺行髓内钉仰卧位治疗的股骨干骨折患者,按照远端锁钉方式的不同分组,其中芯钻髓内钉组21例,普通髓内钉组17例。2组患者对治疗及试验方案均知情同意,且得到医院伦理委员会批准。比较2组治疗方式的临床效果。结果与结论:①与普通髓内钉组相比,芯钻髓内钉组手术时间短[(191.76±25.04)minvs.(156.90±23.36)min]、远端锁定操作时间短[(1223.47±165.92)svs.(497.19±82.78)s]、术中透视次数少[(22.18±3.05)次vs.(12.81±2.64)次]、术中失血量少[(371.18±129.42)mLvs.(192.86±83.13)mL]、远端锁定钉定位准确率高(79.41%vs.95.24%),差异有显著性意义(P<0.05);②2组骨折愈合时间相仿、髋膝关节功能恢复情况相仿(P>0.05);③所有病例均获随访,随访时间14-27个月,均无内固定物断裂,全部患者均达到骨性愈合;④其中芯钻远端锁定髓内钉组表浅感染1例,予以加强换药,抗感染处理后康复,骨折愈合良好;普通髓内钉组表浅感染1例,予以加强换药,抗感染处理后康复,骨折愈合良好;远端螺钉松动1例未予特殊处理,给予延长下地负重时间及随访时间,最终获得愈合;⑤提示芯钻远端锁定髓内钉治疗股骨干骨折锁定操作时间短,准确率高,术中透视次数及失血少,临床效果满意。
BACKGROUND: Accurate and rapid insertion of distal locking nail of femoral intramedullary nail is still a difficult problem. The distal locking accuracy of common intramedullary nail is low, with long time-consuming and intensive radiation. OBJECTIVE: To investigate the characteristics and efficacy of intramedullary nailing with core drill distal locking system in the treatment of adult femoral shaft fractures. METHODS: From January 2014 to December 2016, patients with femoral shaft fracture undergoing treatment of supine position with anterograde intramedullary nail in the Third Affiliated Hospital of Anhui Medical University were retrospectively analyzed. They were treated with core drill distal locking system intramedullary nail(n=21;observation group) and common intramedullary nail(n=17;control group). Both groups of patients signed informed consent to the treatment and trial plan. This study was approved by the Hospital Ethics Committee. The clinical effects of the two groups were compared. RESULTS AND CONCLUSION:(1) Compared to the control group, the operation time was shorter [(191.76±25.04) minutes vs.(156.90± 23.36) minutes];the distal locking operation time was shorter [(1 223.47±165.92) seconds vs.(497.19±82.78) seconds];the fluoroscopy times were less [(22.18±3.05) times vs.(12.81±2.64) times];the blood loss was less [(371.18±129.42) mL vs.(192.86±83.13) mL];location accuracy rate of distal locking nail was high [79.41% vs. 95.24%] in the observation group, showing significant differences(P < 0.05).(2) The healing time of fracture was similar and the functional recovery of hip and knee joint was similar between the two groups(P > 0.05).(3) All cases were followed up for 14 to 27 months. No fracture of internal fixator occurred. All patients achieved bone healing.(4) In the observation group, one case had superficial infection, which healed well after strengthening dressing change and anti-infection treatment. In the control group, one case had superficial infection, and the fracture healed wel
作者
陶勇
江渟
田克超
Tao Yong;Jiang Ting;Tian Kechao(Department of Orthopedics, Third Affiliated Hospital of Anhui Medical University (Hefei First People’s Hospital), Hefei 230061, Anhui Province, China)
出处
《中国组织工程研究》
CAS
北大核心
2019年第36期5800-5805,共6页
Chinese Journal of Tissue Engineering Research
基金
国家卫生计生委医药卫生科技发展研究中心项目(W2015QJ062)，项目参与人：江渟、田克超~~
关键词
股骨干骨折
芯钻系统
远端锁定
交锁髓内钉
随访
髋关节功能
膝关节功能
femoral shaft fracture
core drilling system
distal locking
interlocking intramedullary nail
follow-up
hip function
knee function
