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三级护理中心微创髓内锁钉治疗股骨骨折我们的经验

摘要

大量的研究证实了封闭髓内钉的优点;然而，在某些情况下，小切口技术可能是替代和有利的。评价小开口髓内钉治疗股骨骨折患者的疗效、便捷性和疗效，并与既往报道进行比较。对30例股骨骨折患者行小开锁钉治疗的疗效进行了评估。评估内容包括髋关节、膝关节活动度、肢体长度差异、延迟愈合、畸形愈合、不愈合、感染、植入物失败及术后疼痛等并发症。对患者进行了功能评估，并据此进行了分级，其中包括对准不良、旋转、缩短等标准。术后也对膝关节屈曲和伸展进行评估。结果:优秀者23例，良者3例，一般者4例。3例患者在随访16周时膝关节屈曲受限超过90º。80%的个体在不到19周的时间内发生愈合。 Infection was seen in our series in two patients (6.66%). Delayed union (defined as the presence of inadequate callus at 16 weeks post operatively) was seen in our series in four patients (13.33%). Sixteen percent patients had complications like implant failure or quadriceps wasting. A secondary procedure like dynamisation was required in 13% of the individuals. The mini-open reamed interlocking intramedullary nailing for fractures of the femoral shaft is an excellent modality of treatment. It appears that all fractures from the lesser trochanter to the femoral condyles such as transverse, comminuted, spiral, segmental, oblique fracture can be treated successfully by this technique. Moreover the fractures of the upper third and lower third which is difficult to reduce by closed technique can be treated better with open technique with lesser complications.

Sudeep Shetty, Vinay V Bangera, Bhaskara Bhandary, Prashanth Mohan和Sudarshan Bhandary

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