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髓内钉(IMN)与钢板两种方法治疗股骨干骨折的疗效比较。

Comparison of treatment results of femoral shaft fracture with two methods of intramedullary nail (IMN) and plate.

机构信息

Department of Orthopedics, Mashhad University of Medical Sciences, Mashhad, Iran.

Department of Orthopedics, School of Medicine, Imam Khomeini Hospital, Jiroft University of Medical Science, Jiroft, Iran.

出版信息

BMC Surg. 2024 Oct 18;24(1):318. doi: 10.1186/s12893-024-02590-1.

Abstract

BACKGROUND

Fracture of the femur is one of the most common fractures that, if not stabilized and treated properly, may lead to severe disability, impairment of the individual's efficiency, and numerous complications. This study aimed to evaluate the treatment results of femoral shaft fracture with two methods intramedullary nail (IMN) and Plate.

MATERIALS AND METHODS

In this cross-sectional study, 60 patients with femoral bone fractures were admitted to Imam Khomeini Hospital in Jiroft in 2020 and were treated for at least one year after discharge. They were divided into two treatment groups - Plate fracture fixation (n = 30) and IMN fracture fixation (n = 30). Data were collected using a researcher-made checklist including patient demographics and treatment outcomes. The collected data were analyzed using SPSS-v 26 statistical software and descriptive and inferential statistical tests at a significance level of p < 0.05.

RESULTS

Patients in the Plate treatment group were generally older (50-60 years) compared to the IMN treatment group (30-40 years), and there were more men than women in both groups. Only 10% of patients in each group developed superficial infections after surgery. There were more cases of deep infections in the Plate group, but it was not statistically significant. The IMN group had fewer cases of malignancy and claudication compared to the Plate group. Patients in the IMN group also returned to functional activities faster than those in the Plate group, which was a statistically significant difference.

CONCLUSION

Considering that deep infection, non-union, malunion, claudication, and ability to return to functional activities in the group using nails treated was less than the group treated with plates, the treatment method of femoral fracture using IMN is the preferred treatment method.

摘要

背景

股骨骨折是最常见的骨折之一,如果不稳定和治疗不当,可能导致严重的残疾、个人效率受损和许多并发症。本研究旨在评估髓内钉(IMN)和钢板两种方法治疗股骨干骨折的治疗效果。

材料和方法

在这项横断面研究中,2020 年共有 60 名股骨骨折患者入住 Jiroft 的伊玛目霍梅尼医院,出院后至少接受了一年的治疗。他们被分为两组治疗-钢板骨折固定(n=30)和 IMN 骨折固定(n=30)。使用研究人员制作的检查表收集患者人口统计学和治疗结果数据。使用 SPSS-v 26 统计软件对收集的数据进行分析,并在显著性水平 p<0.05 下进行描述性和推断性统计检验。

结果

与 IMN 治疗组(30-40 岁)相比,钢板治疗组患者年龄普遍较大(50-60 岁),且两组中男性多于女性。手术后,每组只有 10%的患者发生浅表感染。钢板组深部感染的病例较多,但无统计学意义。与钢板组相比,IMN 组恶性肿瘤和跛行的病例较少。与钢板组相比,IMN 组患者更快地恢复功能活动,这是一个统计学上显著的差异。

结论

考虑到使用钉子治疗的组的深部感染、不愈合、畸形愈合、跛行和恢复功能活动的能力比用钢板治疗的组少,因此使用 IMN 治疗股骨骨折的方法是首选的治疗方法。

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The geriatric distal femur fracture: nail, plate or both?老年股骨远端骨折:髓内钉、钢板还是两者都用?
Eur J Orthop Surg Traumatol. 2023 Jul;33(5):1485-1493. doi: 10.1007/s00590-022-03337-5. Epub 2022 Jul 27.
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