交锁髓内钉与膨胀髓内钉治疗股骨干骨折的对比研究

目的比较交锁髓内钉与膨胀髓内钉在治疗股骨干中段骨折（AO分型32A、32B1）上各自的优缺点,评估两者临床疗效以指导临床治疗,帮助临床骨科医生选择最适合患者的个体化治疗方案。方法从2006年6月~2011年3月,20例股骨干骨折患者在我院接受了膨胀髓内钉方案手术治疗（A组）。选择另外20例患有股骨干骨折且接受了交锁髓内钉方案手术治疗的患者（B组）。按照骨折的AO分型,患者均属于32A和32B1。比较两组患者的手术时间、住院时间、出血量、X光暴露剂量、术后负重时间以及有无并发症等,并记录数据。结果所有患者均随访12~24个月,两组患者均达到了骨愈合。A组在出血量、住院时间、手术时间和X光暴露剂量方面优于B组,但是在术后负重时间上,两组患者无明显区别。结论同交锁髓内钉相比,膨胀髓内钉可以缩短手术时间、住院时间,减少术中出血量和X光暴露剂量。

Comparative study of treating femoral mid-shaft fractures with expandable and locked nailings

Objective To compare expandable and locked intramedullary nailing for treating femoral mid-shaft fractures of AO type 32A and 32B1. Methods Performed a retrospective analysis of 40 patients with femoral mid-shaft fractures, divided into two groups, one group treated with the expandable intramedullary nailing method （group A）, the other group treated with conventional locked intramedullary nailing （group B）. The two groups were compared with respect to operation time, fluoroscopic time, amount of blood loss, hospitalization time, healing time and complications. Results Followed up for 12~24 months, all the patients achieved bone union. But expandable nailing performed better than locked nailing with respect to operation time, fluoroscopic time, amount of blood loss, hospitalization time and healing time （P＆lt;0.05）. There were no obvious difference in postoperative weight-bearing time between two groups. Conclusion Expandable intramedullary nailing show significant advantages in shortening operation time,hospitalization time and decreasing amount of blood loss,fluoroscopic time in surgery.