Leighton R K, Waddell J P, Kellam J F, Orrell K G
J Trauma. 1986 Oct;26(10):923-6. doi: 10.1097/00005373-198610000-00011.
A retrospective study was performed including only fractures involving the middle three fifths of the femoral shaft with a minimum of 2 years followup. There were 65 fractures in Group I treated with the closed technique utilizing the image intensifier. These were compared with 65 fractures treated with open reduction and nailing. Followup averaged 4 years (Group II). Group 1 had 92% satisfactory results; Group II achieved 97% satisfactory, not statistically significantly different. Our recommendations are delaying the procedure did not appear to be advantageous; excluding the fractures with segmental bicortical loss, there are limited indications for locked nails in these fractures; the decision to use a specific type of internal fixation should be based on the fracture pattern, the surgeon's experience, and the equipment available; if a closed technique is chosen, be prepared to open the fracture if a satisfactory closed reduction cannot be attained. This, in our study, did not increase the risk of reducing the functional result.
进行了一项回顾性研究，仅纳入涉及股骨干中五分之三且随访至少2年的骨折病例。第一组有65例骨折采用利用影像增强器的闭合技术治疗。将这些病例与65例采用切开复位内固定治疗的骨折病例进行比较。第二组平均随访4年。第一组有92%的结果满意；第二组达到97%满意，差异无统计学意义。我们的建议是：延迟手术似乎并无益处；排除伴有节段性双皮质骨缺损的骨折，这些骨折中锁定髓内钉的适应证有限；决定使用特定类型的内固定应基于骨折类型、外科医生的经验和可用设备；如果选择闭合技术，若无法获得满意的闭合复位则准备切开骨折。在我们的研究中，这并未增加降低功能结果的风险。
