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带锁髓内钉治疗股骨干骨折的并发症原因分析及预防
Hits: 2079   Download times: 1331   Received:February 27, 2005    
作者Author单位UnitE-Mail
吴峰 WU Feng 佛山市中医院骨科,广东佛山528000 Department of Orthopaedics,Foshan Hospital of Traditional Chinese Medicine,Foshan Guangdong,528000,China  
卢绍燊 LU Shao-shen 佛山市中医院骨科,广东佛山528000 Department of Orthopaedics,Foshan Hospital of Traditional Chinese Medicine,Foshan Guangdong,528000,China  
叶志军 YE Zhi-jun 佛山市中医院骨科,广东佛山528000 Department of Orthopaedics,Foshan Hospital of Traditional Chinese Medicine,Foshan Guangdong,528000,China  
陈希聪 CHEN Xi-cong 佛山市中医院骨科,广东佛山528000 Department of Orthopaedics,Foshan Hospital of Traditional Chinese Medicine,Foshan Guangdong,528000,China  
期刊信息:《中国骨伤》2005年18卷,第8期,第464-465页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:分析带锁髓内钉治疗股骨干骨折的并发症发生原因,探讨预防措施。

方法:利用带锁髓内钉治疗股骨干骨折521例,男435例,女86例,平均年龄31岁(16~72岁)。骨折按AO分类:A1型57例,A2型66例,A3型96例,B1型62例,B2型99例,B3型75例,C1型33例,C2型21例,C3型12例。

结果:所有患者经11~48个月(平均18个月)的随访,优良率为90.2%。共出现并发症154例:血管损伤2例,神经损伤3例,脂肪栓塞综合征11例,术中骨折7例,感染7例,深静脉栓塞4例,锁钉误穿2例,主钉折断5例,锁钉断裂9例,锁钉松脱13例,术后再骨折7例,骨不连17例,异位骨化23例,膝关节粘连41例,骨折畸形愈合3例,无骨筋膜室综合征,并发症总发生率为29.6%。

结论:应用带锁髓内钉治疗股骨干骨折具有较好的疗效,但需防范带锁髓内钉使用中并发症的出现。
[关键词]:股骨骨折  骨折固定术,髓内  并发症
 
Cause analysis and prevention of the complications of the femoral shaft fractures treated with interlocking nails
Abstract:

Objective:To analyze the causes of the complication of femoral shaft fractures treated with interlocking nails and explore the preventive measures.

Methods:Five hundreds and twenty-one patients(435 male,86 female,the average age of 31 years,ranging in age from 16 to 72 years) were treated with interlocking nail.Femoral shaft fractures were classified by AO principles:Type Al in 57 cases ,A2 in 66,A3 in 96,B1 in 62,B2 in 99,B3 in 75,C1 in 33, C2 in 21,C3 in 12.

Results:All patients were followed up for an average of 18 months(from 11 to 48 months),the excellent and good rate was 90.2%.Among 154 patients with complications:Vascular injuries was found in 2 cases,nerve injuries in 3 cases,fat embolism in 11 cases,fracture during operation in 7 cases,infection in 7 cases,deep venous thrombosis in 4 cases,mis-insertoin of locking nails in 2 cases,main nail broken in 5 cases,locking nail broken in 9 cases,locking nail loose in 13 cases,postoperative re-fractuve in 7 cases,unhealing of fracture in 17 cases,heterotopic ossification in 23 cases,adhesion of knee in 41 cases,malunion in 3 cases.No compartment syndrome was found,with the total incidence of complications being 29.6%.

Conclusion:Interlocking nail is an excellent alternative for the treatment of femoral shaft fractures.But it is necessary to reduce the complication.
KEYWORDS:Femoral fractures  Fracture fixation,intramedullary  Complication
 
引用本文,请按以下格式著录参考文献:
中文格式:吴峰,卢绍燊,叶志军,陈希聪.带锁髓内钉治疗股骨干骨折的并发症原因分析及预防[J].中国骨伤,2005,18(8):464~465
英文格式:WU Feng,LU Shao-shen,YE Zhi-jun,CHEN Xi-cong.Cause analysis and prevention of the complications of the femoral shaft fractures treated with interlocking nails[J].zhongguo gu shang / China J Orthop Trauma ,2005,18(8):464~465
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