Department Of Orthopaedics & Traumatology, National Orthopedic Hospital, Enugu, Nigeria.
City Specialist Hospital, Enugu, Nigeria.
Int Orthop. 2022 Jan;46(1):13-19. doi: 10.1007/s00264-020-04746-z. Epub 2020 Sep 23.
This was to compare the early outcome of closed femoral shaft fractures treated with locked intramedullary nailing and plating at the National Orthopaedic Hospital Enugu.
The study was a prospective study over 12-month period at the National Orthopaedic Hospital Enugu. Ethical clearance was obtained from the hospital ethical committee. Written informed consent was obtained from all prospectively recruited participants. Patients who met the inclusion criteria were randomly selected by simple balloting into either intramedullary nailing group or plating group. The patients were evaluated at presentation and postoperatively within 48 hours, then at two weeks, six weeks, 12 weeks and 18 weeks, respectively. Participants were evaluated using Thoresen criteria.
A total of 52 femoral shaft fractures in 50 patients were included and analysed using SPSS version 20.0. Bone union was obtained in all the patients in the intramedullary nailing group at 12 weeks and in 84.6% patients in the plating group between 12 and 18 weeks. The overall wound infection rate was 11.5% in the locked intramedullary group and 7.7% in the plating group. Similarly, the overall limb length discrepancy was 11.5% in the locked intramedullary nailing group and 19.2% in the plating group. Based on the Thoresen criteria, good to excellent outcome was achieved in 65.4% of patients in the locked intramedullary nailing group.
The patients in both groups were evaluated clinically, radiologically and functionally based on the Thoresen criteria and significantly higher number of patients in the intramedullary nailing group (17; 65.4%) than the plating group had good to excellent outcome (x = 9.734; p = 0.020).
The early outcome of treatment of closed femoral shaft fractures in adults is significantly better following locked intramedullary nailing than plating.
本研究旨在比较尼日利亚恩古国家骨科医院采用锁定髓内钉和钢板治疗闭合性股骨干骨折的早期结果。
本研究为 12 个月的前瞻性研究，在尼日利亚恩古国家骨科医院进行。医院伦理委员会已获得伦理批准。所有前瞻性招募的参与者均获得书面知情同意。符合纳入标准的患者通过简单抽签随机分为髓内钉组或钢板组。患者在就诊时和术后 48 小时内进行评估，然后分别在 2 周、6 周、12 周和 18 周进行评估。采用 Thoresen 标准进行评估。
共纳入 50 例 52 例股骨干骨折患者，使用 SPSS 版本 20.0 进行分析。髓内钉组所有患者在 12 周时均获得骨愈合，钢板组 84.6%的患者在 12-18 周时获得骨愈合。锁定髓内钉组总的伤口感染率为 11.5%，钢板组为 7.7%。同样，锁定髓内钉组的肢体长度差异总体为 11.5%，钢板组为 19.2%。根据 Thoresen 标准，锁定髓内钉组 65.4%的患者获得良好至优秀的结果。
两组患者均根据 Thoresen 标准进行临床、放射学和功能评估，髓内钉组（17 例；65.4%）显著高于钢板组（x = 9.734；p = 0.020），有良好至优秀结果的患者更多。
与钢板固定相比，锁定髓内钉治疗成人闭合性股骨干骨折的早期结果明显更好。
