切开复位与闭合复位交锁髓内钉内固定治疗股骨干骨折效果观察

目的 对比分析切开复位交锁髓内钉内固定与闭合复位交锁髓内钉内固定治疗股骨干骨折的效果。方法 选取2015年1月至2018年6月收治的78例股骨干骨折患者随机分为观察组和对照组,观察组给予闭合复位交锁髓内钉内固定治疗,对照组给予切开复位交锁髓内钉内固定治疗,比较手术情况、骨折愈合时间、术前及术后6个月HSS评分、术后12个月膝关节功能评价、并发症发生情况、术后12个月综合疗效。结果 观察组术中出血量(165.78±29.34)mL较对照组(451.26±30.02)mL显著减少,骨折愈合时间为(19.36±5.24)周较对照组(31.33±4.48)周显著缩短,差异具有统计学意义(P＜0.05),两组手术时间无统计学差异(P＞0.05),术前两组HSS评分无统计学差异(P＞0.05),术后两组HSS评分均显著提高,且观察组HSS评分提高更显著(P＜0.05),观察组并发症发生率为5.13%较对照组23.08%显著降低,差异具有统计学意义(P＜0.05),术后12个月观察组、对照组综合疗效、膝关节功能优良率分别为94.87%vs87.18%、94.87%vs89.74%,差异无统计学意义(P＞0.05)。结论 切开复位交锁髓内钉内固定与闭合复位交锁髓内钉内固定治疗股骨干骨折疗效相当,但是闭合复位可减轻对患者创伤,缩短骨折愈合时间,降低术后并发症的发生率,促进膝关节功能的恢复,值得在临床上推广。

Observation on the effect of open reduction and closed reduction interlockingintramedullary nailing for the treatment of femoral shaft fracture

Objective To compare the effect of open reduction and interlocking intramedullary nailing and closed reduction and interlocking intramedullary nailing in the treatment of femoral shaft fractures.Methods To select 78 patients with femoral shaft fractures admitted from January 2015 to June 2018 and divide them into observation group and control group randomly.The observation group was treated with closed reduction and interlocking intramedullary nailing,and the control group was treated with open reduction and interlocking intramedullary nailing.To compare the surgical conditions,fracture healing time,preoperative and postoperative 6 months HS S-score 12 months postoperative knee function evaluation,complications,and 12-month postoperative outcome.Results The intraoperative blood loss (165.78±29.34) mL was significantly reduced in the observation group compared with the control group (451.26±30.02) mL.The fracture healing time was significantly shorter (19.36±5.24) weeks than the control group (31.33±4.48) weeks.Statistical significance(P＜0.05),there was no significant difference in operation time between the two groups(P＞0.05).There was no significant difference in HSS score between the two groups before operation(P＞0.05).The HSS scores of the two groups were significantly improved after operation. The HSS score of the observation group was significantly increased(P＜0.05).The complication rate of the observation group was 5.13%,which was significantly lower than that of the control group (23.08%).The difference was statistically significant(P＜0.05).The observation group and control group were 12 months after operation.The comprehensive efficacy and knee function were 94.87% vs 88.18%,94.87% vs 89.74%,respectively,and the difference was not statistically significant (P＞0.05).Conclusion Open reduction and interlocking intramedullary nail fixation and closure Reconstructive interlocking intramedullary nailing for the treatment of femoral shaft fractures is equivalent,but closed reduction can reduce trauma to patients,shorten fracture healing time,reduce the incidence of postoperative complications,and promote the recovery of knee function.It is recommended to promote clinically.