【摘要】 目的对半环形牵开复位器闭合复位辅助交锁髓内钉内固定和手指引导法交锁髓内钉内固定方法治疗股骨干骨折的效果进行对比研究。方法手指引导法68例,复位器闭合方法63例。对2种方法的手术参与人数、手术时间、输血量、术中所需X线透视时间、并发症、功能评分进行统计对比。结果内旋畸形差异显著,复位器组63例中有17例(27%)内旋>10°;手指引导开放组仅为5例(6%),P<0.05。手术时间手指引导开放组平均116min(65～170min);复位器闭合组平均136min(110～192min),P<0.05。手术人员在手指引导法2人可完成而应用复位器则至少3人。手指引导组11例各输血400ml,复位器组无输血病例。手指引导法术中不需X线透视,闭合方法平均透视时间6min(4～11min)。并发症如股骨长度缩短>2cm者在手指引导组有12例,复位器组仅2例,P<0.05。结论手指引导法适合横断型骨折,复位器闭合复位手术适用于粉碎骨折。更多还原

【Abstract】 Objective To compare the therapeutic effect of semi-ring distractor closed method and finger-guided open procedure combined with femoral intramedullary nailing on femoral shaft fracture.Methods131 patients with femoral shaft fracture were randomly divided into two groups,68 patients in finger-guided group were treated by finger-guided method; the other 63 patients in distractor group were treatedby semi-ring distractor closed method. The number of surgical participant,operative time,quantity of blood transfusion,X-ray time during operation,complications,functional scores were recorded and compared in the two groups.ResultsInternal malrotation was significantly more common in distractor group with 17/63(27%) internally rotated by >10°,as compared with 5/68(6%) in finger-guided group(P<0.05).When the finger-guided method was used the average time was 116 min(65～170 min);the finger-guided was 136 min(110～192 min,P<0.05),The operation needed two operator at least in finger-guided group but three in distractor group. There were 11 patients each of whom received 400 ml blood in finger-guided group,but no blood transfusion in distractor group. X-ray was not needed in finger-guided group,however,the average time using image intensifier was 6 minutes (4～11min) in distractor group. There were 12 cases who had femoral shortening in finger-guide group,but only 2 cases in distractor group(P<0.01). The cases who had femoral shortening were all comminuted fractures. There was no significant difference between the two groups with regard to functional state of the patient duringone year.ConclusionThe finger-guided method is suitable for transverse fractures,however,distractor method is suitable for comminuted fractures.更多还原