微创交锁髓内钉技术治疗股骨干骨折的疗效分析

目的:探讨全闭合复位交锁髓内钉固定,配合股骨远端徒手锁钉技术治疗股骨干骨折的疗效。方法:采用全闭合复位髓内钉固定治疗股骨骨折,辅以股骨远端徒手锁钉技术治疗13例股骨干骨折患者,共18例股骨,男9例,女4例;左侧10例,右侧8例;年龄17-53岁,平均36.3岁。根据AO分型:A1型3例,A2型3例,A3型2例;B1型2例,B2型5例,B3型1例;C1型1例,C2型1例。记录手术时间、术中出血量、术中透视时间、术后近期并发症及术后住院时间等。结果:手术时间平均为60(45-135)min,出血量平均为155(50-280)ml。术中透视时间平均为95(50-170)s。无中转为切开复位内固定病例,平均住院时间为15(14-18)d。1例双股骨干骨折患者术后并发脂肪栓塞,治疗后痊愈。所有患者术后获6-18个月(平均10个月)随访,骨折临床愈合时间为5-11个月(平均8个月)。对膝关节功能评定按照Klemm功能恢复标准评价术后疗效,优14例,良4例,优良率100%。无明显的术后近期并发症。结论:全闭合复位徒手锁钉技术治疗股骨干骨折具有手术时间短、出血少、创伤小,患肢功能及骨折愈合快等优点,进一步发挥了交锁髓内钉优势,效果良好。

Effects of Minimally Invasive Interlocking Intramedullary Nail on the Treatment of Femoral Shaft Fractures

Objective: To study the effect of minimally invasive interlocking intramedullary nail on the treatment of femoral shaft fractures.Methods: From September 2009 to May 2011,13 cases with 18 femoral shaft fractures were treated with internal fixation by minimally invasive interlocking intramedullary nail,closed reduction and minimally invasive locking pin in distal femur.X-ray follow-up was made after operation to observe bone healing.Results: All 13 cases were followed up for an average of 10 months(6-18 months).All cases got bone healing in an average time of 8 months.According to the rating scale of Klemm,14 fractures got excellent outcomes,and 4 fractures got improved outcomes.No complications occurred.Conclusion: In the treatment of femoral shaft fracture,the methods of closed reduction and minimally invasive locking pin with intramedullary nail provide reliable effects.