闭合复位和切开复位交锁髓内钉内固定对股骨干骨折患者膝关节功能的影响.docVIP

闭合复位和切开复位交锁髓内钉内固定对股骨干骨折患者膝关节功能的影响 　　摘要：目的 观察股骨干骨折闭合复位和切开复位交锁髓内钉内固定后患者膝关节功能。方法 选取在我院就诊的股骨干骨折患者40例，将其随机分为两组，各20例。观察组用闭合复位交锁髓内钉内固定术，对照组用切开复位交锁髓内钉内固定术，对比两组膝关节功能。结果 对照组膝关节功能评分明显低于观察组，差异显著（P0.05）。结论 给予股骨干骨折患者闭合复位交锁髓内钉内固定术的疗效显著，可明显改善患者膝关节功能。 　　关键词：闭合复位；切开复位；交锁髓内钉内固定；股骨干骨折 　　Abstract：Objective To observe the knee joint function of patients after the interlocking intramedullary nail internal fixation of closed reduction and open reduction in femoral shaft fracture. Methods 40 selected patients with femoral shaft fracture treated in the hospital were randomly divided into two groups， 20 cases in each. Observation group took interlocking intramedullary nail internal fixation of closed reduction and control group took interlocking intramedullary nail internal fixation of open reduction. The knee joint function and postoperative complications of patients of two groups were compared. Results The knee joint function score of control group was significantly lower than observation group， and the incidence of postoperative complications of control group was significantly higher than observation group （P0.05）. Conclusion Interlocking intramedullary nail internal fixation of closed reduction for treating femoral shaft fracture can significantly improve patients knee joint function and decrease the incidence of postoperative complications. 　　Key words：Closed reduction； Open reduction； Interlocking intramedullary nail internal fixation；Femoral shaft fracture 　　股骨干骨折在?R床上比较多见，主要由强大暴力所导致，多发于青壮年[1]。随着科学技术不断发展，髓内钉固定技术已应用于股骨干骨折治疗中。随着微创手术在骨科中的应用，闭合复位交锁髓内钉内固定术已逐渐应用于股骨干骨折治疗中，且取得较好效果[2]。因此，本研究探讨了给予股骨干骨折患者闭合复位和切开复位交锁髓内钉内固定术治疗对膝关节功能的影响。结果如下。 　　1 资料与方法 　　1.1一般资料 选取2011年11月～2015年12月在我院就诊的股骨干骨折患者40例，将其随机分为两组，观察组和对照组，各20例。观察组男12例，女8例；平均年龄为（35.5±6.8）岁；对照组男11例，女9例；平均年龄为（36.2±6.5）岁。排除标准：病理性骨折；GustiloⅡ度以上严重开放性骨折；伴有神经或血管损伤。两组一般资料对比，无明显差异（P0.05）。 　　1.2方法 观察组用闭合复位交锁髓内钉内固定术，患者全麻后行气管插管，仰卧位，行一约5 cm直切口在股骨大粗隆顶点向上处，分离臀中肌，不暴露大粗隆，用食指触摸股骨梨状窝并准确定位后插入导针，矫正骨折近远端，并闭合复位，在骨折端至股骨髁上位置将导针插入，复位难时，术中用C型臂X线机辅助牵引复位，按次序