股骨干骨折三维闭合复位器的研制与临床应用

目的 探讨自行设计并研制股骨干骨折三维闭合复位器在股骨干骨折闭合复位顺行髓内钉内固定术中的临床效果。 方法 2019年7月~2021年6月，术中使用自行研制股骨干骨折三维闭合复位器在骨折闭合复位顺行髓内钉固定治疗股骨干骨折患者68例，其中男46例，女22例，年龄18~75岁，平均35.8岁。骨折按A0分型：32A型35例，32B型22例，32C型11例。受伤至手术时间4~12d，平均6d。评估手术时间、术中出血量、骨折复位时间、骨折愈合时间。 结果 手术时间80~130 min，平均95 min。术中出血量100~200 ml，平均160ml。骨折复位时间5~30 min，平均20 min。68例获6~24个月（平均13.5个月）随访。骨折全部愈合，愈合时间4.0~10.5个月，平均6.0个月。无医源性骨折、感染、神经血管损伤、断钉及其他并发症发生。 结论 股骨干骨折三维闭合复位器操作方便，有效辅助股骨干骨折闭合复位，并能维持骨折复位行髓内钉内固定术，有较高临床应用价值。

Development and clinical application of three-dimensional closed reduction device for femoral shaft fracture

Objective To investigate the efficacy of utilizing a self-designed and developed three-dimensional closed reduction device for femoral shaft fracture in closed reduction and antegrade intramedullary nailing. Methods From July, 2019 to June, 2021, 68 patients with femoral shaft fractures were treated with a self-developed three-dimensional closed reduction device for antegrade intramedullary nail fixation during operation, including 46 males and 22 females, aged from 18 to 75 years, with an average of 35.8 years. According to A0 classification, there were 35 cases of type 32a, 22 cases of type 32B and 11 cases of type 32c. The interval from injury to operation was 4~12 days, with an average of 6 days. The operation duration, intraoperative blood loss, time spent on fracture reduction and time taken to achieve healing were evaluated. Results The operation duration was 80~130 minutes, with an average of 95 minutes. The intraoperative bleeding volume was 100~200 ml, with an average of 160 ml. The time spent on fracture reduction was 5~30 min, with an average of 20min. 68 cases were followed up for 6~24 months (averaging 13.5 months). All fractures healed, and the time taken to achieve healing was 4.0~10.5 months, with an average of 6.0 months. No iatrogenic fracture, infection, neurovascular injury, nail breakage and other complications occurred. Conclusions The three-dimensional closed reduction device for femoral shaft fracture is easy to operate, can effectively assist the closed reduction of femoral shaft fracture, maintain the fracture reduction for intramedullary nail internal fixation.