田召彦 卢兴玉 耿庆学 周泰鹏 刘长

[摘要] 目的 探讨带锁髓内钉与锁定钢板内固定治疗成人股骨骨折疗效。方法 2014年6月—2017年6月方便选择在该院接受治疗的成人股骨骨折患者114例作为研究对象，以简单随机法将其分为对照组和观察组，每组患者57例，对照組给予锁定钢板内固定治疗，观察组行带锁髓内钉治疗，观察对比两组患者治疗情况和不良症状发生情况。结果 就治疗总有效率而言，观察组为94.74%，较对照组80.70%高且差异有统计学意义（P<0.05）；相较于对照组，观察组患者手术时间（87.18±5.43）min、愈合时间（16.22±3.15）d较短，术中出血量（289.32±10.17）mL、术后引流量（67.87±7.98）mL较少（P<0.05）；就感染、术后内固定物松动、内固定物断裂等不良症状而言，观察组发生率为5.26%明显低于对照组17.54%（P<0.05）。结论 相较于锁定钢板内固定，在成人股骨骨折治疗过程中，带锁髓内钉优势明显，创伤小、恢复快，且有利于改善患者关节功能，值得广泛推广。

[关键词] 带锁髓内钉；锁定钢板内固定；成人股骨骨折；临床疗效

[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2018）03（a）-0030-03

Comparison of the Curative Effect of Interlocking Intramedullary Nailing and Locking Plate Internal Fixation on Adult Femoral Fracture

TIAN Zhao-yan， LU Xing-yu， GENG Qing-xue， ZHOU Tai-peng， LIU Chang

Huantai Qifeng Orthopedic Hospital， Zibo， Shandong Province， 256400 China

[Abstract] Objective This paper tries to explore the effect of interlocking intramedullary nailing and locking plate internal fixation in the treatment of adult femoral fracture. Methods From June 2014 to June 2017， 114 patients with adult femoral fractures who were convenient treated in this hospital were selected as the study subjects. They were divided into control group and observation group by simple randomized method. Each group of 57 patients were given the control group lock plate internal fixation treatment， observation group with interlocking intramedullary nail treatment， the treatment was observed in two groups compared with the incidence of adverse symptoms. Results The total effective rate was 94.74% in the observation group and 80.70% in the control group， with a significant difference （P<0.05）. Compared with the control group， the observation group had significantly shorter operative time （87.18±5.43） min and healing time（16.22±3.15）d was shorter， blood loss was （289.32 ± 10.17）mL， postoperative drainage volume was（67.87±7.98）mL less（P<0.05）. Infection， postoperative internal fixation loosening， internal fixation fracture and other adverse symptoms， the observation group incidence was 5.26%， was significantly lower than the control group of 17.54%（P<0.05）. Conclusion Compared with the locking plate fixation， in the process of treatment of adult femoral fracture， interlocking intramedullary nail has obvious advantages， small trauma， rapid recovery， and help to improve the patients joint function， it is worth widely disseminated.

[Key words] Interlocking intramedullary nailing； Locking plate internal fixation； Adult femoral fracture； Clinical curative effect

股骨骨折为临床常见骨折类型，临床以青壮年为高发人群，此类骨折具有解剖学和生物力学特点，骨折不稳定性明显，同时伴有软组织损伤，极易出现骨不连或骨折愈合缓慢等情况，不利于患者病情恢复[1]。临床治疗以手术治疗为主，且近年来带锁髓内钉治疗方式应用广泛，临床治疗效果尤为理想。该次研究基于上述背景，方便选取2014年6月—2017年6月该院收治的成人股骨骨折患者114例作為研究对象，探讨了带锁髓内钉与锁定钢板内固定治疗成人股骨骨折疗效，现报道如下。

1 资料与方法

1.1 一般资料

方便选择在该院接受治疗的成人股骨骨折患者114例作为研究对象，以简单随机法将其分为对照组和观察组，每组患者57例。对照组男29例，女28例，年龄25～58岁，平均（46.13±2.29）岁，Winquist 分型：Ⅱ型 32例、Ⅲ型 15例、Ⅳ型 10例；观察组男30例，女27例，年龄24～59岁，平均（47.47±3.08）岁，Winquist 分型：Ⅱ型 31例、Ⅲ型 17例、Ⅳ型 9例。……