一期交锁髓内钉内固定治疗双侧股骨干骨折
股骨干骨折,,股骨干骨折；,交锁髓内钉；,手术治疗,摘要,关键词,1临床资料,2结果,3讨论,参考文献
摘 要：[目的]探讨一期交锁髓内钉(IIN)内固定治疗双侧股骨干骨折(FSF)的疗效和应用价值。[方法]自1998年3月～2005年3月，21例双侧FSF采用一期IIN治疗。年龄29～48岁，平均396岁，闭合性骨折35肢，开放性骨折7肢。其中股骨上1/3段18肢，中1/3段11肢，下1/3段13肢。术后平均5 d开始CPM功能锻炼。[结果]21例均获得随访，随访时间6～32个月，平均115个月。所有骨折均获得骨性愈合，平均愈合时间155周。无脂肪栓塞综合征(FES)、肢体短缩、感染及断钉发生。远期疗效按马元璋标准评定，肢体关节功能恢复优良率905%(19/21)。[结论]应用一期IIN治疗双侧FSF，具有创伤小、术中出血少、固定牢靠、骨折愈合时间短、允许双膝关节早期功能锻炼和术后并发症少等优点，可获得满意疗效，值得推广。FES的预防要予以重视。
关键词：股骨干骨折； 交锁髓内钉； 手术治疗
中图分类号 R683.42
Initial fixation with locked intramedullary nailing for the treatment of bilateral femoral shaft fracture
ZHANG Haibo,ZHANG Shiqing,WANG Yisheng.
Department of Orthopedics,the First People's Hospital of Kaifeng City,Henan 475000
Abstract：[Objective]To investigate the efficacy and the application value of interlocked intramedullary nailing (IIN) for bilateral femoral shaft fracture (FSF).[Method]Twentyone cases of bilateral FSF were treated by IIN between March 1998 and March 2005. Their average age was 39.6 (ranged 29～48). Thirtyfive limbs of them were closed fractures, and 7 limbs were opened.Among them,18 limbs had fractures in the upper third of the femoral shaft, 11 limbs in the middle third and 13 limbs in the lower third. The continuous passive motion began averaging 5 days after operation.[Result]The average followup period was 11.5 months (6 to 32 months).Clinical bone healing was achieved after 15.5 weeks (10~30 weeks).NO fat embolism syndrome(FES), shortening,infection or break of nail occurred in all patients.The long term effect was evaluated according to Ma Yuanzhang's evaluation standard, 90.5%(19/ 21) showed excellent function of joints and limbs.[Conclusion]IIN provides a satisfied approach to the treatment of bilateral FSF.It has the advantages of fewer invasions,less blood loss,steady fixation,short healing time, early function recovery and less complication. This kind of treatment is worth to be recommended for the bilateral FSF,prevention of FES should be emphasized on. ......
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