带锁髓内钉内固定治疗下肢长管骨骨折的临床疗效分析

目的评估微创下带锁髓内钉内固定术治疗下肢长管骨骨折的临床疗效。方法 2003年3月～2010年9月在微创下行带锁髓内钉内固定术治疗的下肢长管骨骨折患者86例为A组,予手法复位骨折穿钉54例,小切口开放复位穿钉32例;1993年9月～2003年2月行传统内固定术的71例(B组),对两组临床疗效进行比较。结果所有病人术后均获得12～30个月随访,平均18个月。除4例骨折延迟愈合外,其余病人均如期达到骨性愈合。微创下带锁髓内钉内固定技术与传统内固定技术(动力加压钢板内固定、梅花针+钢丝内固定)疗效比较,前者明显优于后者,差异有显著性(P<0.05)。前者并发症发生率明显低于后者(P<0.05)。结论微创下带锁髓内钉内固定术治疗下肢长管骨骨折能防止短缩与旋转,固定可靠,具有创伤小、手术时间短、骨折愈合快、能早期活动及并发症少等优点,且治疗费用低,是目前一种比较理想的内固定治疗方法。

Clinical Evaluation of the Therapeutic Effect of Internal Fixation with Interlocking Intramedullary Nail in the Treatment of Lower Extremity Long Bones Fractures

Objective To evaluate the clinical therapeutic effect of internal fixation with interlocking intramedullary nall in the treatment of lower extremity long bones fractures. Methods 86 cases of lower extremity long bone fractured patients who were treated with interlocking intramedullary nail fixation from March 2003 to September 2010 were includ- ed as Group A, including 54 cases of manual reduction with nail and 32 cases of small incision open reduction with nail; while 71 cases treated with traditional fixation from September 1993 to February 2003 were included as Group B. The clinical therapeutic effects of these two groups were compared. Results Results Follow-up ranged from 12 to 30 months （meanly,18 months）. All patients achieved bone healing except for 4 cases of delayed fracture healing. The efficacy of minimally invasive interlocking intramedullary nail fixation was significantly better than the traditional fixation （P〈 0.05）, and its complications was fewer than the traditional one （P〈0. 05）. Conclusion Minimally invasive interlocking intramedullary nail fixation is a good way to treat the lower extremity long bone fracture. It can prevent the shortening and rotation, it is a reliable fixation with smaller trauma and shorter operative time. It allows fracture healing fast, early movements and fewer complications. And the cost of this treatment is low. It is an ideal internal fixation.