Jiang Wei, Lin Yan, Kotian Ronak Naveenchandra, Xie Wen-Qing, Li Yu-Sheng, Li Guang-Heng, Hu Xin-Jia, Xie Jin-Hu, Liu Wen-Tao, Zhang Xiao-Ming
Department of Bone and Joint, Shenzhen People's Hospital, The First Affiliated Hospital of Nanfan University of Science and Technology, The Second Clinical Medical College of Jinan University Shenzhen 518020, Guangdong, P. R. China.
Department of Orthopaedic Surgery, Victoria Hospital, Bangalore Medical College and Research Institute Bangalore, India.
Am J Transl Res. 2020 Jul 15;12(7):3917-3925. eCollection 2020.
In this study, a new type of reduction device for femoral shaft fractures was developed and designed. The reduction procedure was also standardized and is expected to be useful in clinical practice.
A bone traction retractor that consisted of a special traction needle, a resistant sleeve, a crossbar and an arc-adjusting bar was designed. Forty-eight patients (32 males and 16 females, mean age 33.21±7.03 years old) with femoral shaft fractures treated in our hospital from January 2016 to December 2017 were selected. According to the AO classification, there were 15 patients with type A, 24 patients with type B and 9 patients with type C fractures. All patients were treated with transverse bone traction for closed reduction of femoral shaft fractures and femoral reconstruction with intramedullary nails for final fixation. The injured side, preoperative delay time, reduction and operative times, operative blood loss, drilling frequency, number of open reduction cases, hospitalization days, fracture healing time, postoperative HSS function score and complications were recorded.
All 48 patients were treated with transverse bone traction using our novel device to obtain reduction. The average time needed for reduction was 19.98±4.66 min. The operating time was 60-100 min, with an average of 78.65±16.81 min, and the average intraoperative blood loss was 131.91±30.22 ml. Open reduction was performed in 8 patients: 1 patient in the experimental group and 7 patients in the control group. The average hospitalization days was 7.78±2.81 days, the fracture healing time was 10 to 15 weeks, with an average of 12.44±2.63 weeks, and the postoperative HSS score was 80-95 points, with an average of 86.52±6.03 points. None of the patients had coxa vara, nonunion, internal fixation failure, infection, nerve injury, limb length discrepancy or other complications.
In this study, the transverse bone traction reduction technique and the design of a proprietary reduction device system were proposed, with high clinical application. The transverse bone traction reduction technique has the advantages of simple operation, reliable reduction and limited intraoperative fluoroscopy in the minimally invasive treatment of femoral shaft fractures.
本研究开发并设计了一种新型股骨干骨折复位装置。复位操作也进行了标准化，有望在临床实践中发挥作用。
设计一种骨牵引牵开器，其由特殊牵引针、阻力套筒、横杆和弧形调节杆组成。选取2016年1月至2017年12月在我院治疗的48例股骨干骨折患者（男32例，女16例，平均年龄33.21±7.03岁）。根据AO分类，A型骨折15例，B型骨折24例，C型骨折9例。所有患者均采用横向骨牵引进行股骨干骨折闭合复位，最终采用髓内钉进行股骨重建固定。记录患侧、术前延迟时间、复位及手术时间、术中出血量、钻孔频率、切开复位病例数、住院天数、骨折愈合时间、术后HSS功能评分及并发症。
48例患者均采用我们的新型装置进行横向骨牵引以实现复位。平均复位所需时间为19.98±4.66分钟。手术时间为60 - 100分钟，平均为78.65±16.81分钟，术中平均出血量为131.91±30.22毫升。8例患者进行了切开复位：实验组1例，对照组7例。平均住院天数为7.78±2.81天，骨折愈合时间为10至15周，平均为12.44±2.63周，术后HSS评分为80 - 95分，平均为86.52±6.03分。所有患者均未出现髋内翻、骨不连、内固定失败、感染、神经损伤、肢体长度差异或其他并发症。
本研究提出了横向骨牵引复位技术及 proprietary复位装置系统的设计，具有较高的临床应用价值。横向骨牵引复位技术在股骨干骨折微创治疗中具有操作简单、复位可靠、术中透视有限等优点。
