股骨交锁髓内针远端锁钉困难原因分析及对策

目的探讨股骨交锁髓内针远端锁钉困难的原因及对策。方法2007年1月至2007年9月期间共进行69侧股骨髓内针的手术,其手术步骤和锁定技术按照传统的方法进行。2007年10月至2008年10月期间共进行88侧股骨髓内针的手术,其手术步骤和锁定技术按照改良的方法进行。传统方法组与改良方法组治疗后的一次锁定成功率比较采用卡方检验,以P〈0.05为差异有统计学意义。结果传统方法组一次锁定成功54侧,成功率为78.26%。改良方法组一次锁定成功79例,成功率为89.77%。两组比较X2=3.95,P〈0.05,结果有显著性差异。结论股骨交锁髓内针远端锁钉困难的原因是多方面的,应该从病人入院后的准备到手术结束的各个环节中注意改进。

To analyze reasons and strategies of distal locking diffeculties in femoral intramedullary nail

Objective To analyze reasons and strategies of distal locking diffeculties in femoral intramedullary nail with matched tar-get device. Methods The investigation was performed from Jan. 2007 to Oct.2008. A total of 149 femur fracture cases were divided into traditional method group and improved method group and operating procedures and locking technologies were processed according rules in individual. The rate of first-time success of traditional method group and improved method group was compared by chi square test. Results During the operation, the rate of first-time success of distal locking in traditional method group was 78.26%;while in improved method group was 89.77%. There was significant difference in two group（Х^2= 3.95,P〈0.05）. Conclusion Various factors existed for distal locking in femoral nail with matched target device. In order to raise the rate of first-time success for distal locking, every links during the opertion must be emphasize, including preoperative preparation.