交锁髓内钉与钢板内固定治疗股骨骨折的疗效对比

摘要

Objective To analyse the efficacy of intramedullary nail and plate fixation on femoral fractures,in order to provide a bet-ter way to treat femoral fractures.Methods Seventy patients with femoral fractures from December 2010 to December 2013 in our hospital were to be studied.According to the method of randomized clinical trial,patients were divided into two groups,with 35 cases in each group;treatment group were treated with interlocking intramedullary nail and the control group with plate fixation; then the general index,healing time,load time,knee mobility,ankle mobility and the incidence of postoperative complications were observed in two groups of patients.Results The operative time and blood loss of treatment group was (64.3 ±3.7) min and (76.4 ±2.6) ml,significantly better than the control group,which was (94.6 ±6.4) min and (243.7 ±2.3) ml,and the difference was statistically significant between the two groups;the healing time and load time of treatment group was (22.6 ±5.4) weeks,(11.2 ±6.8) weeks,significantly shorter than the control group,which was (39.7 ±6.3) weeks and (19.7 ±6.3) weeks,and the difference was statistically significant between the two groups;postoperative knee and ankle joints showed similar degrees in patients ,and the difference was not statistically significant;in treatment group,one case had postopera-tive infection,one case had knee joint pain,and one case had delayed fracture healing,so the complication rate was 8.57%,which was signifi-cantly lower than 25.71%in the control group,and the difference was statistically significant between the two groups.Conclusion Compared with intramedullary nail,plate fixation in the treatment of femoral fractures can significantly shorten the average operative time,blood loss, fracture healing time and reduce superficial infection rate,delayed fracture healing rate,and nonunion rate,thus it could be widely used in clinical femoral intramedullary nail in the treatment of femur fractures.%目的：探讨交锁髓内钉与钢板内固定治疗股骨骨折的疗效。方法选取股骨骨折患者70例进行分析，按照随机数字表将患者分为两组，每组各35例，其中治疗组采用交锁髓内钉进行治疗，对照组采用钢板内固定进行治疗，观察两组患者术中一般指标，愈合时间、负重时间、膝关节活动度、踝关节动度以及术后并发症发生情况。结果治疗组手术时间及术中出血量分别为（64．3±3．7）min和（76．4±2．6）mL，优于对照组的（94．6±6．4）min和（243．7±2．3）mL，差异有统计学意义（P＜0．05）；治疗组骨折愈合时间（22．6±5．4）周、负重时间为（11．2±6．8）周，短于对照组的（39．7±6．3）周和（19．7±6．3）周，差异有统计学意义（P＜0．05）；两组患者术后膝关节及踝关节活动度相似，差异无统计学意义（P＞0．05）；治疗组术后感染1例，膝关节疼痛1例，骨折延迟愈合1例，并发症发生率为8．57％，小于对照组的25．71％，差异有统计学意义（P＜0．05）。结论交锁髓内钉组在平均手术时间、术中出血量、骨折愈合时间、骨折延迟愈合率、骨折不愈合率等方面优于钢板内固定组。