| ObjectiveThrough a retrospective study of100cases of adult femoral shaft fracture clinicaldata and the results of treatment, compared with femoral interlocking intramedullarynail and plate internal fixation for the treatment of adults with femoral shaft fracture,and provide the basis for clinical treatment of adult femoral shaft fracture fixation.MethodsSelect100cases of adult patients with femoral shaft fracture from2008Februaryto2011September in the Second Affiliated Hospital of Dalian Medical University,whohad been underwent respectively femoral interlocking intramedullary nail and theplate,were retrospectively studied, divided into intramedullary nail group and the plategroup, including the use of intramedullary interlocking nail in the treatment of patientswith50cases and the use of the plate with50patients, two groups were observed inpatients with operation time, intraoperative bleeding volume, average length of stay,fracture healing time, superficial infection, delayed union, nonunion rate, the rate ofinternal fixation breakage rate, reoperation rate, good rate of limb function after surgeryfor fracture, were statistically analysis of all data. All data analyses were performedusing SPSS11.5software.ResultsAll patients were successfully completed the operation, all patients were followedup, follow up time was1.6~5years, average2.3years. All patients and noosteomyelitis and malunion. Intramedullary nail group operation time and plate groupoperation time respectively were (66.3±2.6) min and (93.5±5.3) min, there wassignificant difference between the two groups (P<0.01), showed that intramedullarynail group operation time is shorter than plate group; Intramedullary nail groupintraoperative bleeding volume and plate group intraoperative bleeding volume respectively were (75.2±2.8) ml and (233.3±3.3) ml, there was significant differencebetween the two groups (P<0.01), showed that intramedullary nail group intraoperativebleeding volume is less than plate group; intramedullary nail group patients hospitalizeddays and plate group patients hospitalized days respectively were (13.5±4)d and (17.9±4.6) d, there was significant difference between two groups (P<0.01), showed thatintramedullary nail group patients hospitalization days is shorter than plate group;intramedullary nail fracture healing time and plate group fracture healing time were(151±10.3)d and (191.5±9.8)d, there was significant difference between the twogroups (P<0.01), showed that intramedullary nail group fracture healing time is shorterthan plate group fracture healing time; intramedullary nail group superficial infectionrate and plate group superficial infection rate were respectively0%and6%,there wassignificant difference between two groups (P<0.05), showed that intramedullary nailgroup superficial infection rate is lower than plate group superficial infection rate;intramedullary nail group delay healing rate and plate group delay healing rate wererespectively2%and10%,there was significant difference between two groups(P<0.05), showed that intramedullary nail group delay healing rate is lower than plategroup delay healing rate; Intramedullary nail group patients with nonunion occurred in2cases,plate group were nonunion occurred in6cases, intramedullary nail groupnonunion rate and plate group nonunion rate were respectively4%and12%,there wassignificant difference between two groups (P<0.05), showed that intramedullary nailgroup nonunion rate is lower than plate group nonunion rate; There was1case internalfixation breakage in intramedullary nail group, there was7cases internal fixationbreakage in plate group, the rate of internal fixation breakage of intramedullary nailgroup and plate group were respectively2%and14%,there was significant differencebetween two groups (P<0.05), showed that the rate of internal fixation breakage ofintramedullary nail group is lower than the rate of internal fixation breakage of plategroup;intramedullary nail group patients reoperation occurred in3cases, plate groupreoperation occurred in13cases, intramedullary nail group and plate group reoperationrate were6%and26%, there was significant difference between two groups(P<0.05), showed that intramedullary nail group patients reoperation rate is lower thanplate group; intramedullary nail groups patients with postoperative limb function wasexcellent in39cases, good in7cases, the excellent and good rate was92%, plate grouppatients with postoperative limb function was excellent in25cases, good in11cases,the excellent and good rate was72%, there was significant difference between two groups (P<0.05), showed that the excellent and good rate of intramedullary nail grouppatients is higher than plate group.ConclusionFrom the statistical data in the present study, compared with the plate internalfixation for the treatment of femoral shaft fracture, intramedullary femoral nails cansignificantly shorten the average operation time, intraoperative blood loss, length ofhospital stay, fracture healing time, reduce superficial infection rate, delayed healingrate, nonunion rate, breakage of internal fixation, reoperation rate, improve the excellentand good rate of limb function, therefore, we advocate that femoral interlockingintramedullary nail should be widely used in the treatment of adult femoral shaftfracture in clinic practice. |
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