带锁髓内钉固定对股骨干骨折后骨不连患者预后情况及膝关节功能的影响分析

张守军

【摘要】 目的：探讨带锁髓内钉固定对股骨干骨折后骨不连患者预后情况及膝关节功能的影响。方法：选取2017年1月-2018年12月笔者所在医院收治的82例股骨干骨折后骨不连患者为研究对象，根据入院顺序编号，按照随机数字表法分为对照组和观察组，各41例。对照组采用动力加压钢板内固定治疗，观察组采用带锁髓内钉固定治疗。比较两组手术指标、Lysholm评分、ADL评分及并发症发生情况。结果：观察组手术时间明显短于对照组，术后引流量明显少于对照组，差异均有统计学意义（P<0.05）。术后两组Lysholm评分、ADL评分均较术前明显升高，且观察组明显高于对照组，差异有统计学意义（P<0.05）。观察组并发症发生率为7.32%，对照组并发症发生率为17.07%，两组比较差异无统计学意义（P>0.05）。结论：带锁髓内钉固定可明显改善股骨干骨折后骨不连患者的膝关节功能和预后生存质量，临床积极作用明显。

【关键词】 股骨干骨折 骨不连 带锁髓内钉 预后 膝关节功能

doi：10.14033/j.cnki.cfmr.2019.29.070 文献标识码 B 文章编号 1674-6805（2019）29-0-03

[Abstract] Objective： To investigate the effect of interlocking intramedullary nail fixation on prognosis and knee joint function of patients with nonunion after femoral shaft fracture. Method： A total of 82 patients with nonunion after femoral shaft fracture who were admitted in our hospital from January 2017to December 2018 were selected as the subjects. According to the order of admission， they were divided into the control group and the observation group by random number table method， 41 cases in each group. The control group was treated with dynamic compression plate internal fixation， while the observation group was treated with interlocking intramedullary nail fixation. The operation indexes， Lysholm score， ADL score and complications were compared between the two groups. Result： The operation time of the observation group was significantly shorter than that of the control group， and postoperative drainage volume was significantly less than that of control group， the differences were statistically significant （P<0.05）. The Lysholm score and ADL score of the two groups after operation were significantly higher than those before operation， and the observation group was significantly higher than the control group， the differences was statistically significant （P<0.05）. The incidence of complications was 7.32% in the observation group and 17.07% in the control group. There was no significant difference between the two groups （P>0.05）. Conclusion： Interlocking intramedullary nail fixation can significantly improve knee joint function and prognosis quality of life in patients with nonunion after femoral shaft fracture. The clinical positive effect is obvious.

[Key words] Femoral shaft fracture Nonunion Interlocking intramedullary nail Prognosis Knee joint function

First-authors address： Laifeng Wuling Mountain Orthopaedic Hospital， Laifeng 445700， China

股骨干骨折為临床常见多发病，发生率约占全身骨折的6%，而股骨干骨折患者中约有5%～10%的患者可能出现骨不连情况[1-2]。股骨干骨折后骨不连系指骨折部位经治疗后受诸多因素影响而较难正常愈合的情况，骨不连会增加患者疼痛症状，并严重影响患者肢体功能和日常活动能力[3]。如何有效改善股骨干骨折后骨不连患者预后情况及膝关节功能是目前临床研究的重点，常明洁[4]的研究证实，带锁髓内钉固定在股骨干骨折后骨不连患者的治疗中有一定效果，但有关带锁髓内钉固定对股骨干骨折后骨不连患者预后情况及膝关节功能的影响尚缺乏统一定论。本研究特选取82例股骨干骨折后骨不连患者，分别进行带锁髓内钉固定治疗和动力加压钢板内固定治疗，旨在比较两种治疗方案对股骨干骨折后骨不连患者预后及膝关节功能的影响，具体结果报告如下。……