交锁髓内钉与锁定加压钢板内固定治疗成人股骨干骨折临床疗效对比

摘要

Objective To investigate a reasonable treatment for femoral shaft fracture by comparison of therapeuctic effects between interlocking intramedullary nail (IMN) and locking compression plate (LCP). Methods Clinical data of 126 adult patients with femoral shaft fracture treated by the above two kinds of internal fixation methods from March 2009 to May 2013 in Chancheng Hospital of Foshan First People's Hospital were analyzed retrospectively. According to different kinds of internal fixation, the patients were divided into interlocking IMN group (n = 70) and LCP group ( n = 56). The estimate blood loss, length of hospital stay, fracture healing time, excellent and good rate for clinical effect at the last follow-up, as well as complication incidence in two groups were compared and analyzed. Results Estimate blood loss, length of hospital stay in interlocking IMN group and LCP group was (386 ± 53) mL, (41 ± 4) d and (419 ± 66) mL, (49 ± 6) d respectively, the differences were statistically significant (P <0.05). All patients were followed-up with the average time of 11.6 months (ranged, 9-27 months). In interlocking IMN group and LCP group, fracture healing time was (4.5 ± 1.1) months and (5.6 ± 1.3) months; excellent and good rates evaluated at the last follow-up were 97%(68/70) and 86%(48/56), complication rates were 6% (4/70) and 18% (10/56). The differences had statistical significance between the above data in two groups (P <0.05). Conclusion Compared with LCP, treatment of interlocking IMN for adult femoral shaft fracture could achieve comparable curative effect with less estimate blood loss, shorter length of hospital stay, less fracture healing time and lower complication incidence.%目的：对比分析交锁髓内钉和锁定加压钢板内固定治疗成人股骨干骨折的疗效差异，探讨合理的治疗方法。方法回顾性分析2009年3月至2013年5月佛山市第一人民医院禅城医院收治的126例成人股骨干骨折患者的临床资料，根据内固定材料的不同分为交锁髓内钉组（70例）和锁定加压钢板组（56例），对两组出血量、住院时间、骨折愈合时间、末次随访临床疗效优良率、并发症发生情况进行比较。结果交锁髓内钉组和锁定加压钢板组出血量、住院时间分别为（386±53）mL、（41±4）d和（419±66）mL、（49±6）d，两组比较，差异均有统计学意义（P＜0.05）。两组患者均获随访，随访时间9～27个月（平均11.6个月）。交锁髓内钉组和锁定加压钢板组骨折平均愈合时间分别为（4.5±1.1）个月和（5.6±1.3）个月；末次随访时临床疗效优良率分别为97%（68/70）和86%（48/56）；并发症发生率分别为6%（4/70）和18%（10/56）。两组上述指标比较，差异均有统计学意义（P＜0.05）。结论与锁定加压钢板内固定术相比，交锁髓内钉治疗成人股骨干骨折具有出血量少、住院时间短、骨折愈合快、并发症少、临床疗效显著等优势。