Fan Ke-Jie, Chen Ke, Ma Wen-Long, Tian Ke-Wei, Ye Ye, Chen Hong-Gan, Tang Yan-Feng, Cai Hong-Min
Henan Province, Luoyang Orthopedic Hospital, Henan Province Orthopedic Hospital, Luoyang 471002, Henan, China.
Henan Province, Luoyang Orthopedic Hospital, Henan Province Orthopedic Hospital, Luoyang 471002, Henan, China;
Zhongguo Gu Shang. 2018 May 25;31(5):472-476. doi: 10.3969/j.issn.1003-0034.2018.05.014.
To investigate the effect of minimally invasive mini-incision and instrumented reduction combined with interlocking intramedullary nailing in the treatment of patients with multi-segment fracture of complex femoral shaft.
From January 2013 to January 2016, 32 patients with multiple fractures segments of femoral shaft were treated with instrumentation-assisted reduction combined with interlocking intramedullary nailing, including 22 males and 10 females with an average age of 45 years old ranging 17 to 68 years old. The time from injured to operation was 5 to 10 days with an average of 7 days. After admission, routine tibial tubercle or supracondylar bone traction was performed. The patient's general condition was evaluated, the operation time and intraoperative blood loss were recorded. According to Thorsen femoral fracture morphology evaluation criteria and Hohl knee function evaluation of postoperative efficacy, postoperative fracture healing, complications and postoperative recovery of limb function were observed.
All patients were followed up for 6 to 24 months with an average of 12 months. The operative time ranged from 48 to 76 minutes with an average of 67 min. The intraoperative blood loss was 150 to 400 ml with an average of 220 ml. The surgical incisions all achieved grade A healing. The fractures reached the clinical standard of healing. The fracture healing time ranged from 4.2 to 10.8 months with an average of 5.7 months. There were no nonunion, incision infection and internal fixation fracture, failure and other complications. According to Thorsen femoral fracture morphology evaluation criteria, the result was excellent in 28 cases, good in 3 cases, fair in 1 case. According to Hohl knee function evaluation criteria, the result was excellent in 30 cases, good in 2 cases.
Instrument-assisted reduction combined with interlocking intramedullary nail fixation is a safe and effective method for the treatment of complex femoral shaft fractures. It has advantages of small trauma, fixed fixation, quick recovery, early postoperative functional exercise.
探讨微创小切口及器械复位联合交锁髓内钉治疗复杂股骨干多段骨折患者的疗效。
2013年1月至2016年1月，对32例股骨干多段骨折患者采用器械辅助复位联合交锁髓内钉治疗，其中男性22例，女性10例，平均年龄45岁，年龄范围17至68岁。受伤至手术时间为5至10天，平均7天。入院后行常规胫骨结节或髁上骨牵引。评估患者一般情况，记录手术时间及术中出血量。根据Thorsen股骨骨折形态学评估标准及Hohl膝关节功能评估术后疗效，观察术后骨折愈合、并发症及肢体功能恢复情况。
所有患者均随访6至24个月，平均12个月。手术时间为48至76分钟，平均67分钟。术中出血量为150至400毫升，平均220毫升。手术切口均达到甲级愈合。骨折达到临床愈合标准。骨折愈合时间为4.2至10.8个月，平均5.7个月。未发生骨不连、切口感染及内固定断裂、失败等并发症。根据Thorsen股骨骨折形态学评估标准，结果为优28例，良3例，可1例。根据Hohl膝关节功能评估标准，结果为优30例，良2例。
器械辅助复位联合交锁髓内钉固定是治疗复杂股骨干骨折的一种安全有效的方法。具有创伤小、固定可靠、恢复快、术后可早期进行功能锻炼等优点。
