本文選題：股骨干骨折 + 逆行髓內(nèi)釘　；參考：《安徽醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:在治療股骨干中段骨折中,股骨髓內(nèi)釘按照手術(shù)入路可分為順行髓內(nèi)釘和逆行髓內(nèi)釘,我們設(shè)計這項臨床研究旨在比較順行髓內(nèi)釘和逆行髓內(nèi)釘在治療股骨干中段骨折方面的異同,以利于在臨床治療中選擇更加合理的術(shù)式,探討髓內(nèi)釘在臨床上更好的應(yīng)用。方法:2014年7月至2016年5月安徽醫(yī)科大學(xué)第一附屬醫(yī)院共76例單側(cè)閉合性股骨干中段骨折被納入這項研究。所有患者的骨折均為急診收治的新鮮骨折,其中被納入順行髓內(nèi)釘治療組(順行釘組)40例,逆行髓內(nèi)釘治療組(逆行釘組)36例。所有患者均經(jīng)至少6個月以上的隨訪,詳細觀察并記錄兩種術(shù)式手術(shù)情況(手術(shù)時間、失血量、有限切開例數(shù))、骨折愈合情況(骨折愈合時間、愈合類型)及術(shù)后恢復(fù)情況(膝關(guān)節(jié)活動度、髖膝關(guān)節(jié)疼痛情況)。應(yīng)用統(tǒng)計學(xué)方法對兩組數(shù)據(jù)進行統(tǒng)計分析得出結(jié)論。結(jié)果:順行釘組手術(shù)時間(125±8)min,逆行釘組手術(shù)時間(114±9)min,兩組比較,P0.05,差異有統(tǒng)計學(xué)意義;順行釘組骨折愈合時間(97±13)d,逆行釘組骨折愈合時間(98±13)d,兩組比較,P0.05,差異無統(tǒng)計學(xué)意義;順行釘組術(shù)后出現(xiàn)膝關(guān)節(jié)疼痛8例(20.0%),逆行釘組術(shù)后出現(xiàn)膝關(guān)節(jié)疼痛19例(52.8%),兩組比較,P0.05;順行釘組術(shù)后出現(xiàn)髖關(guān)節(jié)疼痛7例(17.5%),逆行釘組出現(xiàn)髖關(guān)節(jié)疼痛1例(2.7%),兩組比較,P0.05;膝關(guān)節(jié)早期活動度逆行釘組顯著少于順行釘組,隨著骨折愈合,兩組并無顯著差異。結(jié)論:兩種手術(shù)方案治療股骨干骨折均可取得良好的骨折愈合效果,但逆行釘治療術(shù)后存在較多的膝關(guān)節(jié)疼痛的并發(fā)癥。建議在其適應(yīng)征內(nèi)謹慎、綜合選擇。
[Abstract]:Objective: in the treatment of femoral shaft fractures, femoral intramedullary nail with surgical approach can be divided into antegrade intramedullary nail and retrograde intramedullary nail, we design this study aimed to compare the antegrade intramedullary nail and retrograde intramedullary nail, the similarities and differences in the treatment of femoral shaft fractures in the middle part, in order to facilitate the operation more reasonable in clinical treatment, to explore the application of better in clinical intramedullary nail. Methods: the First Affiliated Hospital of Medical University Of Anhui from July 2014 to May 2016 a total of 76 cases of unilateral closed femoral shaft fractures were included in this study. All patients with fractures were fresh fractures were treated in the emergency department, which is included in the treatment group antegrade intramedullary nailing (antegrade group) 40 cases, treatment group of retrograde intramedullary nail (retrograde nail group) 36 cases. All patients were treated with at least 6 months of follow-up, observed and recorded in detail two operative conditions (operative time, blood loss, have 闄愬垏寮，

本文編號：1730926