| Objectives Through collect the cases of ipsilateral femoral multiple fractures who had received operation in the second hospital of tangshan from January 2014 to January 2016,summarize their diagnosis and treatment process,master the clinical characteristics,analysis the best treatment plan for each type of fracture type,for provide reference for clinical treatment.Methods Searching for the cases of ipsilateral femoral multiple fractures by the retrieval system of the second hospital of Tangshan from January 2014 to January 2016,by looking up their cases and X ray film for further screening to get the cases who conform to the requirements.1 Count up their number,age,causes of injuries,multiple trauma cases and the formation of the lower extremity venous thrombosis in perioperative period,find out the clinical characteristics of this kind of fracture;2 Count up the situation of misdiagnosis,calculate the rate of misdiagnosis,analyze which part are most likely to transpire misdiagnosis;3 C lassify the fractures and their methods of internal fixation,observe or compare their duration of operation,fracture healing time,complications and joint function,analysis the clinical effect of different methods of internal fixation for treatment of a certain type of fracture,get the best treatment of each type of fracture.Results 1 A total of 141 cases are collected,105 cases of male,36 cases of male,aged 20 to 77 years old;66 cases of traffic injuries,22 cases of bruise,41 cases of high falling injury,9 cases of crush injury,9 cases of other injury;119 cases of multiple injury,the incidence rates is 84.4%,48 cases in lower limb venous thrombosis,the incidence rates is 34.04%;2 A total of 10 patients had occurred in diagnosis,the rate of missed diagnosis is 7.1%,5 patients are missed the fracture of femoral neck,4 patients are missed the fracture of femoral condyle,1 patient was missed the fracture of femoral shaft;3 The numbers of AB fracture type are 65,34 patients are treated by one internal fixation,the operating time:(93.79±9.70)min,the healing time:(17.67±2.79)weeks,5 patients had complications,The excellent and good rate of hip joint function is 82.4%,31 patients are treated by two kinds of internal fixation,the operating time:(86.43±7.44)min,the healing time:(17.90±2.98)weeks,4 patients had complications,The excellent and good rate of hip joint function is 83.9%,through the statistical comparison,the two kinds of operation method have no difference in healing time,complications and joint function,but the method by by two kinds of internal fixation need a shorter time;Except the 4 patients that only fixed the fracture of shaft,the numbers of BC fracture type are 37,24 patients are treated by steel plate,the operating time:(93.68±7.04)min,the healing time:(18.17±3.56)weeks,4 patients had complications,The excellent and good rate of knee joint function is 75.0%,13 patients are treated by two kinds of internal fixation,the operating time:(92.50±6.57)min,the healing time:(18.08±3.48)weeks,2 patients had complications,The excellent and good rate of knee joint function is 76.9%,through the statistical comparison,the two kinds of operation method have no difference in d uration of operation,healing time,complications and joint function;The numbers of BB fracture type are 37,all treated by intramedullary nail,1 patients had complications,The excellent and good rate of knee joint function is 92.3%,The excellent and good rate of knee joint function is 88.5%;The numbers of AC fracture type are 6,all treated by two kinds of internal fixation,the excellent and good rate of hip joint function is 83.33%,the excellent and good rate of knee joint function is 100%;The numbers of ABC fracture type are 7,A and B were treated together,C was treated alone,t he excellent and good rate of hip joint function is 85.7%,the excellent and good rate of knee joint function is 85.7%.Conclusions 1 In addition to fractures,the patients often accompanied by other injuries,and easy to have a lower limb venous thrombosis during the perioperation,the incidence is 34.0%.2 The patients are easy to be misdiagnosed and the rate of misdiagnosis is 7.1%,and the fractures of femoral neck and femoral condyle are easily overlooked.3 The operation method that choosing two fixations is the first choice to treat the AB fracture;The operation methods that choosing one internal fixation or two fixations both can be used in the treatment of fractures;Using the intramedullary nail in the treatment of BB fracture can get a good therapeutic result;Using two kinds of internal fixation in the treatment of AC fracture can get a good therapeutic result;Using the method that A and B were fixed together and C was fixed alone in the treatment of ABC fracture can get a good therapeutic result. |
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