逆行和顺行置髓内钉治疗股骨干骨折的疗效比较

目的比较逆行和顺行置髓内钉治疗股骨干骨折的临床疗效。方法将57例股骨干骨折患者按置钉方式的不同分为对照组(经大转子顺行置髓内钉治疗,25例)和观察组(经股骨髁逆行置髓内钉治疗,32例)。比较两组术中透视次数、手术时间、术中出血量、骨折愈合时间、术后6个月Harris评分。结果患者均获得随访,时间7~12个月。手术时间、术中出血量观察组明显短(少)于对照组(P<0.05);术中透视次数、骨折愈合时间以及术后6个月Harris评分两组比较差异均无统计学意义(P>0.05)。结论逆行和顺行置髓内钉治疗股骨干骨折均能取得满意的临床疗效,但逆行置髓内钉具有手术操作简单、无需使用牵引床、手术时间短、术中出血量少等优点,更利于基层医院使用。

Comparison effect between retrograde and antegrade intramedullary nailing in the treatment of femoral shaft fractures

Objective To compare the clinical effect of retrograde and antegrade intramedullary nailing in the treatment of femoral shaft fractures.Methods The 57 patients with femoral shaft fractures were divided into control group(25 cases were treated with anterograde intramedullary nailing via greater trochanter)and observation group(32 cases were treated with retrograde intramedullary nailing via femoral condyle)according to different nailing methods.Intraoperative fluoroscopy times,operation time,intraoperative blood loss,fracture healing time,and Harris score at 6 months after surgery were compared between the two groups.Results All patients were followed up for 7~12 months.The operative time and intraoperative blood loss in the observation group were significantly shorter(less)than those in the control group(P<0.05).There were no statistically significant differences in intraoperative fluoroscopy times,fracture healing time,or Harris score at 6 months after surgery(P>0.05).Conclusions Both retrograde and anterograde intramedullary nailing can achieve satisfactory clinical efficacy in the treatment of femoral shaft fractures.However,retrograde intramedullary nailing has the advantages of simple operation,no need for traction bed,short operation time and less intraoperative blood loss,etc.,and is more beneficial to the use of basic hospitals.