[1]朱晓波,郑杰,钱晶晶.顺势双反牵引复位器复位髓内钉内固定治疗股骨干骨折的临床研究[J].中医正骨,2023,35(01):20-24.
　ZHU Xiaobo,ZHENG Jie,QIAN Jingjing.A clinical study of homeopathic double reverse traction repositor-assisted reduction and intramedullary nailing internal fixation for treatment of femoral shaft fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(01):20-24.
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顺势双反牵引复位器复位髓内钉内固定治疗股骨干骨折的临床研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期数:
2023年01期
页码:
20-24
栏目:
临床研究
出版日期:
2023-01-20

文章信息/Info

Title:
A clinical study of homeopathic double reverse traction repositor-assisted reduction and intramedullary nailing internal fixation for treatment of femoral shaft fractures
作者:
朱晓波; 郑杰; 钱晶晶
(舟山医院,浙江 舟山 316021)
Author(s):
ZHU Xiaobo; ZHENG Jie; QIAN Jingjing
Zhoushan Hospital,Zhoushan 316021,Zhejiang,China
关键词:
股骨骨折;  牵引术;  骨折固定术; 髓内;  骨钉;  临床试验
Keywords:
femoral fractures;  traction;  fracture fixation; intramedullary;  bone nails;  clinical trial
摘要:
目的:观察顺势双反牵引复位器复位髓内钉内固定治疗股骨干骨折的临床疗效及安全性。方法:回顾性分析2019年5月至2021年5月收治的30例股骨干骨折患者的病例资料,均采用髓内钉内固定治疗,其中15例采用顺势双反牵引复位器复位(复位器组)、15例采用牵引床复位(牵引床组)。比较2组患者的复位时间、术中X线透视次数、手术时间、术中出血量,以及术后2周膝部疼痛视觉模拟量表(visual analogue scale,VAS)评分、术后6个月美国特种外科医院(Hospital for Special Surgery,HSS)膝关节评分、术后并发症发生情况。结果:2组患者骨折均愈合。复位器组在复位时间、术中X线透视次数、手术时间、术中出血量、术后2周膝部疼痛VAS评分方面均优于牵引床组[(8.36±2.53)min,(20.27±5.38)min,t=12.390,P=0.000;(10.51±3.22)次,(18.64±2.73)次,t=7.459,P=0.000;(85.22±20.34)min,(110.56±21.25)min,t=3.336,P=0.002;(120.23±21.68)mL,(180.67±21.23)mL,t=7.714,P=0.000;(3.27±2.02)分,(5.20±1.97)分,t=-2.665,P=0.013]; 2组患者术后6个月HSS膝关节评分比较,组间差异无统计学意义[(88.22±6.34)分,(80.32±2.71)分,t=1.146,P=0.261]。术后复位器组出现下肢深静脉血栓1例、下肢力线不良1例,牵引床组出现下肢深静脉血栓1例、会阴部挤压伤3例、足踝部挤压伤1例、切口脂肪液化1例、腓总神经损伤2例、下肢力线不良2例、贫血1例,复位器组的并发症发生率低于牵引床组(P=0.003)。结论:顺势双反牵引复位器复位髓内钉内固定治疗股骨干骨折,与牵引床复位髓内钉内固定相比,两者在膝关节功能恢复方面无明显差异,但前者比后者的复位时间短、术中X线透视次数少、手术时间短、术中出血量少、术后膝部疼痛改善情况好,且并发症少。
Abstract:
Objective:To observe the clinical efficacy and safety of homeopathic double reverse traction repositor(DRTR)-assisted reduction and intramedullary nailing(IMN)internal fixation for treatment of femoral shaft fractures.Methods:The medical data of 30 patients with femoral shaft fractures admitted from May 2019 to May 2021 were retrospectively analyzed.All patients were treated with IMN.Specifically,15 cases underwent homeopathic DRTR-assisted reduction(DRTR group),while the remaining 15 cases underwent traction table-assisted reduction(traction table group).The reduction time,intraoperative X-ray exposure,operation time,and intraoperative blood loss,as well as the Visual Analogue Scale(VAS)score evaluated for knee pain at two weeks after operation,Hospital for Special Surgery(HSS)knee score evaluated at six months after operation,and incidence of postoperative complications were compared between the two groups.Results:Fracture healing was observed in both groups.The DRTR group was superior to the traction table group in reduction time,intraoperative X-ray exposure,operation time,intraoperative blood loss,and VAS score evaluated for knee pain at two weeks after surgery(8.36±2.53 vs 20.27±5.38 min,t=12.390,P=0.000; 10.51±3.22 vs 18.64±2.73,t=7.459,P=0.000; 85.22±20.34 vs 110.56±21.25 min,t=3.336,P=0.002; 120.23±21.68 vs 180.67±21.23 mL,t=7.714,P=0.000; 3.27±2.02 vs 5.20±1.97,t=-2.665,P=0.013).There was no significant difference in HSS knee score between the two groups at six months after operation(88.22±6.34 vs 80.32±2.71,t=1.146,P=0.261).In the DRTR group,deep vein thrombosis(DVT)occurred in one case and poor lower limb alignment in one case.In the traction table group,DVT occurred in one case,perineal crush injury in three cases,ankle crush injury in one case,fat liquefaction in the incision in one case,peroneal nerve injury in two cases,poor lower limb alignment in two cases,and anemia in one case.The incidence of complications in the DRTR group was lower than that in the traction table group(P=0.003).Conclusion:In terms of functional recovery of knee joint,homeopathic DRTR-assisted reduction and IMN internal fixation in the treatment of femoral fractures was comparative to traction table-assisted reduction and IMN internal fixation,but the former showed shorter reduction time,less intraoperative X-ray exposure,shorter operation time,less intraoperative blood loss,better improvement of postoperative knee pain,and fewer complications.

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(收稿日期:2022-07-25 本文编辑:郭毅曼)

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备注/Memo

备注/Memo:
通讯作者:郑杰 E-mail:zhengjie1682000@aliyun.com
更新日期/Last Update: 1900-01-01