| Objectives To compare the healing time of fracture and limb function between two groups after operation,analyse the clinical therapeutic effect of interlocking intramedullary nail and locking compression plate in the treatment of femoral shaft fracture nonunion.So as to provide reference for clinical treatment of femoral shaft fracture nonunion.Methods Collect the clinical cases of femoral shaft fracture nonunion from November 2011 to November 2016 admitted by Affiliated Hospital of North China University and the Affiliated The Second Hospital of Tangshan.Choose 61 cases which were treated for femoral shaft fracture nonunion by interlocking intramedullary nail and locking compression plate through the inclusion and exclusion criteria.Recorde the general information of the cases,the imaging data and the related data of the operation,take them into the retrospective statistical analysis.The whole 61 cases were divided into group A(interlocking intramedullary nail group)and group B(locking compression plate group)according to the different methods of operation.A group has 29 cases,involving 20 cases of male and 9 cases of female with age from 18 to 64(averagely 41.62±12.52)years.16 cases on the left side,and 13 cases on the right side.The reason of injury: 13 cases were injured by traffic accident,9 cases were injured by falling,7 cases were injured by crush.Original fracture type according to AO principles: 13 cases were simple fractures,8 cases were wedge fractures and 8 cases were complex fractures.There are 24 closed fracture cases and 5 open fracture cases in this group.The first treatment: 21 cases treated by intramedullary nail fixation,and 8 cases treated by plate fixation.Form of nonunion according to AO principles: 15 cases were hypertrophic,9 cases were atrophy,5 cases were ischemia type.The nonunion time were from 11 to 35(averagely 21.34±6.47)months.B group has 32 cases,involving 22 cases of male and 10 cases of female with age from 22 to 64(averagely 43.59±11.66)years.16 cases on the left side,and 16 cases on the right side.The reason of injury: 18 cases were injured by traffic accident,10 cases were injured by falling,4 cases were injured by crush.Original fracture type: 15 cases were simple fractures,8 cases were wedge fractures and 9 cases were complex fractures.There are 27 closed fracture cases and 5 open fracture cases in this group.The first treatment: 25 cases treated by intramedullary nail fixation,and 7 cases treated by plate fixation.Form of nonunion : 18 cases were hypertrophic,8 cases were atrophy,6 cases were ischemia type.The nonunion time were from 11 to 40(averagely 22.47±7.36)months.The comparations between two groups about gender,age,injured side,injury mechanism,original fracture type,fracture form,first treatment modality,nonunion pathology and nonunion time have no statistical significance,P>0.05,so they are comparable.Detailly record the operation time,fracture healing time and postoperative limb function recovery of two groups,and process the data with statistical software SPSS17.0,to compare the general effect of interlocking intramedullary nail and locking compression plate in the treatment of femoral shaft fracture nonunion.Results 61 patients received a long's follow-up which from 12 to 24(averagely 16.61±2.97)months.All patients were treated got fracture healing,without complications such as internal fixation failure,infection and important neurovascular injury.The time required for the operation of group A is(118.45±15.42)minites,and the time required for the operation of group B is(132.19±10.16)minites,the differences have statistical significance(t=-4.147,P<0.05).The time of fracture healing of group A is(6.35±0.74)months,and the time of fracture healing of group B is(5.96±0.67)months,the differences have statistical significance(t=2.109,p<0.05).The superior rate for score of the knee joint function of group A is 89.6%,and the superior rate for score of the knee joint function of group B is 78.1%.Comparing the score of the knee joint function of two groups,the differences have no statistical significance(?~2=2.572,P>0.05).Conclusions 1 Interlocking intramedullary nail and locking compression plate are all effective in the treatment of femoral shaft fracture nonunion.2 As the time required for the operation,interlocking intramedullary nail need less time than the locking compression plate.But the locking compression plate is more advantageous in the time of fracture healing,and the time of fracture healing is shorter.3 Interlocking intramedullary nail seems locking compression plate in postoperative recovery of knee joint function. |
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