髓内钉治疗伴有蝶形骨折块的股骨干骨折术中干预的疗效分析

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Abstract Objective To investigate the effect of intramedullary nail on femoral shaft fracture healing by intervening the displaced fracture fragments with degree Ⅱ and above during operation.Methods A retrospective case-control study was conducted to analyze the clinical data of 115 patients with femoral shaft fracture with butterfly fracture admitted to the First People's Hospital of Lianyungang from February 2016 to February 2020，including 58 males and 57 females，62 right and 53 left.The age ranged from 17 to 68 years，with an average of (39.0±11.9)years.There were 71 cases of a traffic accident，18 cases of a fall from height，12 cases of a cycling fall，14 cases of crushing or other according to the cause of injury.The time from injury to surgery was (5.0±2.4)days.According to whether butterfly fracture fragments were intervened during surgery，patients were divided into the intervention group and control group.Interention group had 34 patients with grade Ⅱ displacement，14 patients with grade Ⅲ displacement and 11 patients with grade Ⅳ displacement.The control group had 30 patients with grade Ⅱ displacement，16 patients with grade Ⅲ displacement，and 10 patients with grade Ⅳ displacement.The fracture healing rate，healing time，full weight-bearing time，and the modified Radiological Union Scale for Femur(mRUSF) at 9 months at 9 months after surgery were compared between the groups.Results All 115 patients were followed up for 9~24 months，with an average of (15.2±3.8)months.In cases of grade Ⅱ displacement，the fracture healing rate，healing time，full weight-bearing time，and mRUSF score at 9 months after surgery in the control group were superior to those in the intervention group(P＜0.05).In cases of grade Ⅲ displacement，the fracture healing rate，healing time，full weight-bearing time，and mRUSF score at 9 months after surgery in the control group were superior to those in the intervention group(P＜0.05).In cases of grade Ⅳ displacement，the fracture healing rate，full weight-bearing time，and mRUSF score at 9 months after surgery in the control group were superior to those in the intervention group(P＜0.05).Conclusion During the treatment of femoral shaft fractures with intramedullary nails，intraoperative intervention should be used on the displaced fragments of grade Ⅱ，Ⅲ，and IV to reduce the degree of fragment displacement to grade Ⅰ，which is beneficial to femoral fracture healing.

Key words： femoral shaft fracture fracture fragment intramedullary nail intervention

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	Articles by authors
	Yang Shuo
	Zhang YanYan
	Huo Yongfeng
	Sun Xiao
	Yu jian
	Yin Zhaoyang

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Yang Shuo,Zhang YanYan,Huo Yongfeng, et al. Effect of Intraoperative Intervention in Intramedullary Nail Operation of Femoral Shaft Fracture with Butterfly Fragments[J]. sygkzz, 2022, 28(6): 487-492.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2022/V28/I6/487

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