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1、髓内钉治疗股骨干骨折治疗策略临床回顾［摘耍］冃的：回顾性分析股骨干骨折髓內钉固定术前、术中和术后特点，为临床提供参考。方法：回顾性分析南方医科人学附属南方医院120例股骨干骨折髓内钉同定术前特点及术后并发症等指标，包括病例特点、骨折类型、手术时间、损伤评分、髓内钉类型、手术方法，术后并发症例如感染、股骨颈骨折等指标。结果：大部分手术采用仰卧位(82.5%)、牵引床牵引(57.1%)和顺行固定技术(84.5%)。有59.2%病例为单纯性股骨干骨折,剩余为复合型多发伤，复合型伤和伴有严重胸椎骨折患者手术一般采取延期髓内钉治疗，38.0%的复合严重胸椎损伤
2、的患者一般在创伤后第1天进行髓内钉手术，髓内钉并发症的发生率较低，但是股骨颈骨折发生率较高。结论：大部分股骨干骨折患者髓内钉固定术采用仰卧位顺行植入髄内钉，并发症的发生率较低；对于多发性创伤的患者，需要在创伤后1d内及吋进行髄内钉固定术。［关键词］股骨干；骨折；髓内钉；固定［中图分类号］R683.42［文献标识码］A［文章编号］1673-7210(2011)12(b)-047-03Retrospectivestrategiesforintramedullarynai1inginthetreatmentoffemoralshaftfracturesHA
3、OTingl,YUBini*,FENGWeil,HAOZengtaol,BAOGuoyu21.SouthernMedicalUnivcrsityAffi1iatedNanfangHospital,GuangdongProvince,Guangzhou510515,China;2.DepartmentofOrthopedics,theSecondAffiliatedHospitalofTnnerMongoliaMedicalCol1ege,InnerMongoliaAutonomousRegion,Hohhot010030,China［Abstract
4、］Objective:Toretrospectivedeterminecurrenttechniquesandperioperativecomplicationsofintramedullarynailingofdiaphysealfemoralfractures.Methods:120casesofdiaphysealfemoralfractureswerecollected・Informationaboutfractureclassification,timetooperation,injuryseverityscore,typeofnail,a
5、ndoperativetechnique,aswellasperioperativecomplicationssuchasinfection,femoralnockfracturewereselected.Results:Thepreferredpositionforimplantationwassupinc(82・5%).Mostsurgeonsusedatractiontable(57.1%)andanantegradeimplantationtechnique(84・5%).Tn59.2%ofthecases,anisolatedfemurfr
6、acturewaspresent,whiletherestsustainedmultipleinjuries.Tnpolytraumapatientsandpatientswithseverethoraxinjuries,mostsurgeonswerechosedadelayedtreatmentwithintramedullaryfemoralnails.Interestingly,38.0%ofthepatientswithseverethoraxinjuriesweretreatedonthefirstdaywithintramedullar
7、yfemoralnails.Thetotalrateofcomplicationsforintramedullaryfemoralnailingwas1ow,butahighrateofintraoperativefemoralneckfractureswasobserved.Conclusion:Thevastmajorityofsurgeonspreferthesupinepositionandtheantegradetechniquetoimplantintramedullaryfemoralnails.Theincidencerateofco
8、mplicationislow;Alargenumberofpolytraumapatientsandpat
