扩髓与非扩髓髓内钉在治疗股骨干骨折的比较

目的 探讨髓内钉在治疗股骨干骨折中非扩髓是否比扩髓手术过程更简单、手术时间短、安全。方法 51例简单股骨干骨折病例行股骨髓内钉内固定，A组28例行扩髓，B组23例行非扩髓，所有病例远近端锁钉都锁定。比较A、B两组的手术时间、出血量、围手术期并发症。结果 A组平均手术时间为142min，B组平均手术时问为115min；A组平均出血量为358ml，B组平均出血量为236ml；罔手术期并发症A组3例，B组7例。结论 扩髓髓内钉技术是固定股骨干简单骨折的金标准。非扩髓内钉在治疗简单股骨干骨折较扩髓内钉需要较少的手术时间，随手术时间的缩短手术中出血也相应的减少，但是围手术期并发症发生率较高。

Compare of reamed versus unreamed femoral intramedullary nailing

Objective To probe whether the procedure of undreamed femoral intramedullary nailing is simpler,safer than reamed nailing. .Methods There were 51 patients with isolated unilateral fractures of the femoral diaphysis were either reamed or undreamed locked intramedullary stabilization.28 patients received reamed and 23 received undreamed intramedullary nails.All nails were interlocked proximally and distally.The surgical time ,estimated blood loss,perioperative complication were recorded.Results The average surgical time of the reamed nail group was 142 minutes and undreamed nail group was 115minutes(P=0.011).The estimated blood loss of reamed group was 359millitesand undreamed group was 236millites (P=0.027).3 cases perioperative complication occurred in the reamed nail group and 7 cases in the undreamed group.Conclusion The technique of reamed nailing remains the gold standard for stabilizing femoral diaphysis fracture,although the undreamed nailing involves fewer steps and is faster with less blood loss than reamed nailing,and undreamed nailing was associated with highter incidence perioperative complication.