交锁髓内钉与锁定加压钢板内固定对股骨干骨折患者膝关节功能及创伤相关指标的影响

目的:探讨交锁髓内钉(IIN)与锁定加压钢板(LCP)两种内固定方法对股骨干骨折(FSF)患者膝关节功能及创伤相关指标的影响。方法:回顾性分析2015年1月-2018年3月我院收治的97例FSF患者的临床资料,依照内固定方式的不同分为IIN组(n=54)和LCP组(n=43),比较两组患者的术后骨折愈合情况,围术期指标、创伤相关指标、膝关节功能恢复及并发症情况。结果:术后IIN组骨折愈合优良率为92.59%,高于LCP组的76.74%(P0.05),IIN组患者手术时间、住院时间、术中出血量、术后引流量、骨折愈合时间少于LCP组(P0.05);IIN组浅表感染率、内固定物断裂率、骨折延迟愈合率、不愈合率及血清C反应蛋白(CRP)、去甲肾上腺素(NE)、肾上腺素(E)、超氧化物歧化酶(SOD)水平低于LCP组(P0.05);IIN组患者Fugl-Meyer下肢运动评分、美国膝关节协会(KSS)评分高于LCP组(P0.05)。结论:相较于LCP内固定,IIN内固定对FSF患者的创伤较轻,术后并发症较少,可更好地促进骨折愈合及膝关节功能恢复。

Effects of Interlocking Intramedullary Nail and Locking Compression Plate Internal Fixation on Knee Joint Function and Trauma Related Indexes in Patients with Femoral Shaft Fracture

ABSTRACT Objective: To investigate the effects of two internal fixation methods, interlocking intramedullary nail (IIN) and locking compression plate (LCP) internal fixation on the knee joint function and trauma related indexes in patients with femoral shaft fracture (FSF). Methods: The clinical data of 97 patients with FSF admitted to our hospital from January 2015 to March 2018 were analyzed retrospectively. They were divided into IIN group (n=54) and LCP group (n=43) according to different internal fixation methods. The postoperative fracture healing, perioperative index, trauma related indexes, knee joint function recovery and complications between the two groups were compared. Results: The excellent and good rate of fracture healing in IIN group was 92.59%, which was higher than 76.74% in LCP group (P<0.05). The operation time, hospitalization time, intraoperative blood loss, postoperative drainage and fracture healing time of IIN group were shorter than those of LCP group (P<0.05). The superficial infection rate, internal fixation fracture rate, delayed fracture rate, non-healing rate and serum C-reaction protein (CRP), noradrena-line (NE), epinephrine (E), superoxide dismutase (SOD) levels were lower than those in LCP group (P<0.05). The Fugl Meyer lower extremity motor score and the knee society score (KSS) score of IIN group were higher than those of LCP group (P<0.05). Conclusion: Compared with LCP internal fixation, IIN internal fixation has less trauma and less postoperative complications in patients with FSF, which can better promote fracture healing and knee function recovery.