Chen Ke, Tian Ke-wei, Ye Ye
Zhongguo Gu Shang. 2015 Jul;28(7):606-8.
To study the applied value of double joystick technique in reduction-internal fixation for femoral shaft fracture in adults.
Thirty-four patients (24 males and 10 females) with femoral shaft fractures were treated with reduction assisted by double joystick technique and internal fixation with interlocking intramedullary nail from September 2010 to June 2013. The average age of the patients was 41 years old, ranged from 17 to 65 years old. The duration of the disease course ranged from 3 to 7 days, with a mean of 5 days. The fractures belonged to AO types 32A (5 cases), 32B (20 cases) and 32C (9 cases) and located in left femur for 18 patients and right femur for 16 patients. The patients were followed up, and fracture healing and complications were observed. The curative effect were evaluated according to Thorsen femur fracture evaluation standard.
The operative time ranged from 40 to 110 min (mean 75 min) and intraoperative blood loss ranged from 200 to 300 ml (mean 250 ml). All the patients obtained a good fracture reduction and were followed up for 12 to 24 months (mean 18 months) after the surgery. All the fractures united between 4 and 8 months with a mean of 5 months. No complications such as breakage of nail, infection, osteofascial compartment syndrome, refracture and fracture malunion were found. According to Thorsen femur fracture evaluation standard, 30 patients obtained an excellent result, 3 good and 1 fair.
In surgery of reduction-internal fixation for femoral shaft fracture in adults, the use of double joystick technique obtains good reduction result, short operative time, less injury, high healing rate of bone fractures, less complications and good limbs function, so it is worthy of popularizing in clinic.
探讨双操纵杆技术在成人股骨干骨折切开复位内固定中的应用价值。
选取2010年9月至2013年6月收治的34例股骨干骨折患者(男24例,女10例),采用双操纵杆技术辅助复位,交锁髓内钉内固定。患者平均年龄41岁,年龄范围17~65岁。病程3~7天,平均5天。骨折按AO分型为32A(5例)、32B(20例)、32C(9例),其中左侧18例,右侧16例。术后对患者进行随访,观察骨折愈合情况及并发症发生情况,按Thorsen股骨干骨折疗效评定标准进行疗效评定。
手术时间40~110分钟,平均75分钟;术中出血量200~300毫升,平均250毫升。所有患者骨折均获得良好复位,术后随访12~24个月,平均18个月。骨折均在4~8个月愈合,平均5个月。未发现断钉、感染、骨筋膜室综合征、再骨折及骨折畸形愈合等并发症。按Thorsen股骨干骨折疗效评定标准,优30例,良3例,可1例。
在成人股骨干骨折切开复位内固定术中,应用双操纵杆技术复位效果良好,手术时间短,创伤小,骨折愈合率高,并发症少,肢体功能恢复好,值得临床推广应用。