| Objective: To compare the clinical efficacy of interlocking intramedullary nail combined with lag screw in the treatment of AO-C type femoral shaft fracture,so as to help the clinical selection of surgical methods.Methods: By using retrospective analysis,60 patients with AO-C femoral shaft fractures were treated by Department I of Bone of Affiliated Hospital of Zunyi Medical University from October 2011 to December 2016.They were divided into study group and control group according to different internal fixation materials.The study group had interlocking intramedullary nails combined with lag screw fixation,while the control group had single intramedullary nail fixation,with 30 cases in each group.The study group had 18 males and 12 females,aged 19-61 years,with a mean age of 41.53 ± 12.52 years.There were 10 cases of traffic accident injury,14 cases of heavy load injury,and 6 cases of fall injury,including 10 cases of C1 type,15 cases of C2 type,and 5 cases of C3 type.In the control group,there were 19 males and 11 females,aged 18-62 years,with a mean age of 41.87 ±13.52 years.There were 8 cases of traffic accident injury,20 cases of heavy load injury,and 2 cases of fall injury,including 16 cases of C1 type,8 cases of C2 type and 6 cases of C3 type.According to the follow-up at 1,3,6,9 months and 1 year after operation,the data of operation time,intraoperative blood loss,fracture healing time,fracture healing rate,postoperative complications,knee function score and excellent efficacy were compared between the two groups for statistical analysis.Results: Follow-up was obtained in all cases in this study,with a mean follow-up time of12.3 ± 1.2 months(9-15 months).There was no statistical difference in basic condition,cause of injury,fracture classification between the two groups(P > 0.05).The operation time was 122.51 ± 18.54 min in study group and 115.13 ± 21.02 min in control group,and there was no statistical significance(P > 0.05).The intra-operative hemorrhagic volume was 377.74 ± 66.65 ml in study group and 372.22 ± 57.48 ml in control group,and there was no statistical significance(P > 0.05).The average healing time of fracture in study group was 22.03 ± 9.97 W,while that in control group was 27.78 ± 9.11 W,and there was statistical difference between the two groups(P < 0.05).The knee function score of the study group was 95.06 ± 2.94 points;The knee function score of the control group was90.27 ± 8.45 points,which was statistically significant(P < 0.05).The study group had no corresponding complications,while the control group had 1 case of fracture of main nail,2cases of rotational deformity and 2 cases of delayed bone healing.There was no statistical difference between the two groups(P > 0.05).According to the evaluation criteria of Karlstrom-Olerud femoral fracture,the study group had excellent results in 23 cases,good in 5 cases and fair in 2 cases,the excellent and good rate was 93.33%.The control group was excellent in 19 cases,good in 6 cases,fair in 4 cases and poor in 1 case.The excellent and good rate was 83.33%.The study group was superior to the control group(P < 0.05).Conclusion: Compared with intramedullary nail in the treatment of AO-C type femoral shaft fracture.The interlocking intramedullary nail combined with a lag screw has higher fracture healing rate,shorter healing time,less postoperative complications.It is worth to be popularized in the treatment of AO-C type femoral shaft fracture. |
PDF Full Text Request