摘要
目的探讨应用特殊复位器辅助经皮复位微创髓内钉治疗同侧多节段股骨干骨折的手术方法和临床效果。方法应用特殊复位器辅助复位髓内钉固定治疗24例(男性19例和女性5例)同侧多节段股骨干骨折患者。记录手术时间、术中复位时间、透视时间、术中出血量;观察并记录患者术后患肢骨折愈合时间及功能恢复情况。结果 24例患者术中均通过应用T形钉辅助复位达到闭合复位,其中2例患者需克氏针辅助复位。患者术中平均手术时间(61.4±15.1)min,平均复位时间(11.5±3.5)min,平均透视时间(16.3±5.6)s,平均出血量(183.8±58.0)m L。患者均获得随访,所有骨折平均愈合时间(4.5±3.3)个月,依据Friedman-Wyman疗效评价标准均达到优良。结论应用特殊复位器辅助复位微创髓内钉固定治疗同侧多节段股骨干骨折具有创伤小、出血量小、易复位、手术时间短、骨折愈合率高、并发症少、功能恢复好等优点,值得临床应用和推广。
Objective To evaluate the curative effect and surgical skills of intramedullary nailing(IMN)in the treatment of ipsilateral multisegmental femoral shaft fractures under the assistance of an reduction device by joystick techniques.Methods Twenty-four adult patients with ipsilateral multisegmental femoral shaft fractures,including 19 males and 5 females,were enrolled into this study.All the patients were treated with anterograde IMN by percutaneous and joystick techniques under the assistance of the special reduction device(T-tape pin redaction device).The operation time,reduction time,fluoroscopy time,and intra-operative blood loss were recorded.Follow-up was conducted to assess the healing of the fractures and the functional recovery of the affected limbs.Results All the 24 cases were achieved closed reduction under the assistance of an reduction device by joystick techniques,two patients of them needed kirschner wire for reduction.The average operative time,fracture reduction time,fluoroscopy time and blood loss were(61.4±15.1)min,(11.5±3.5)min,(16.3±5.6)s and(183.8±58.0)mL,respectively.All fractures healed well on an average of(4.5±3.3)months.According to Friedman-Wyman classification 24 cases get good result.Conclusion The method that treated ipsilateral multisegmental femoral shaft fractures with anterograde IMN under the assistance of the T-pin redaction device by percutaneous techniques is a good choice with the advantages of less soft tissue trauma,less intra-operative blood loss,easy reduction,short operative time,high healing rate of bone fractures,less complications and excellent functional recovery,so it is worthy of popularizing in clinic.
作者
王伟
李升
刘建宁
徐国辉
郭跻超
齐向北
WANG Wei;LI Sheng;LIU Jian-ning;XU Guo-hui;GUO Ji-chao;QI Xiang-bei(The Fourth Department of Orthopedics,the Third Hospital of Hebei Medical University,Xiangjiang Hospital Area,Shijiazhuang 050035,China)
出处
《河北医科大学学报》
CAS
2018年第4期413-415,430,共4页
Journal of Hebei Medical University
基金
河北省医学科学研究重点课题(20170638)
关键词
股骨骨折
骨折固定术
髓内钉
femoral fractures
fracture fixation
intramedullary nail
