张言旭

摘要：目的  探讨交锁髓内钉对下肢长管状骨创伤骨折患者膝关节功能及并发症的影响。方法  选取2017年6月～2018年3月我院收治的下肢长管状骨创伤骨折患者100例作为研究对象，采用随机数字表法分为观察组和对照组，每组50例。对照组行钢板内固定术治疗，观察组行交锁髓内钉固定术治疗，比较两组术中出血量、膝关节功能恢复时间、疼痛（VAS）评分及并发症发生情况。结果  观察组术中出血量及膝关节功能恢复时间均低于对照组，差异有统计学意义（P<0.05）;治疗前，两组VAS评分比较，差异无统计学意义（P>0.05）;治疗后，两组VAS评分均降低，且观察组低于对照组，差异有统计学意义（P<0.05）;观察组术后并发症发生率低于对照组，差异有统计学意义（P<0.05）。结论  交锁髓内钉能有效减少下肢长管状骨创伤骨折患者术中出血量及膝关节功能恢复时间，缓解患者疼痛，降低其术后并发症发生率。

关键词：四肢长管骨创伤骨折;钢板螺钉内固定;交锁髓内钉

Abstract：Objective  To investigate the effect of interlocking intramedullary nails on knee joint function and complications in patients with traumatic fractures of long tubular bones of the lower extremities.Methods  A total of 100 patients with long tubular bone trauma fractures of the lower extremities who were admitted to our hospital from June 2017 to March 2018 were selected as the research objects. They were divided into observation group and control group by random number table method， with 50 cases in each group. The control group was treated with steel plate internal fixation， and the observation group was treated with interlocking intramedullary nail fixation. Intraoperative blood loss， knee function recovery time， pain （VAS） score and complications were compared between the two groups.Results  Intraoperative blood loss and knee function recovery time in the observation group were lower than those in the control group，the difference was statistically significant （P<0.05）; before treatment， the difference in VAS scores between the two groups was not statistically significant （P>0.05）; After treatment， the VAS scores of the two groups decreased， and the observation group was lower than the control group， the difference was statistically significant （P<0.05）; the postoperative complication rate of the observation group was lower than the control group， the difference was statistically significant （P<0.05）.Conclusion  The interlocking intramedullary nail can effectively reduce the amount of blood loss and the recovery time of knee joint function in patients with long tubular bone traumatic fractures of the lower extremities， relieve the pain of the patients， and reduce the incidence of postoperative complications.

Key words：Traumatic fractures of limbs and long tubes;Internal fixation with plate screws; Interlocking intramedullary nails

下肢長管状骨创伤骨折是一种发生于四肢的常见骨折，因外伤、疾病等引起的骨结构完整性或连续性破坏，其临床症状主要表现为肿胀、疼痛、功能障碍等[1]。由于其受伤部位通常软组织覆盖率较低，相对缺少充足的血供，四肢长管创伤骨折愈合时间较长，临床常采用手术治疗[2]。传统的治疗方法是采用钢板内固定法治疗下肢长管状骨创伤骨折相较于交锁髓内钉内固定术，创伤较大，疗效不理想。本研究主要分析交锁髓内钉对下肢长管状骨创伤骨折患者膝关节功能及并发症的影响，现报道如下。

1资料与方法

1.1一般资料  选取佳木斯骨科医院2017年6月～2018年3月收治的下肢长管状骨创伤骨折患者100例，采用随机数字表法分为观察组和对照组，每组50例。观察组男34例，女16例;年龄19～78岁，平均年龄（46.22±9.37）岁;股骨骨折28例，胫骨骨折22例;致伤原因：交通事故14例，高空坠伤16例，跌伤17例，其他3例。……