METHODS: This was a retrospective review of 257 patients with femoral shaft fractures treated with IMN at a tertiary trauma medical center. All the IMN inserted were the same (Stryker T2 Femoral Nail). The patients were divided into groups based on nail size (10-, 11-, 12-, or 13-mm) and CN difference (< 1, 1-2, or > 2 mm), and union rate and time to union were compared.
RESULTS: The 10-, 11-, 12-, and 13-mm groups based on nail size had 113, 74, 54, and 16 patients, respectively. The overall union rate was 97% (257/265). No significant differences in union rate or time to union were observed among these 4 groups. The groups based on CN differences of < 1-, 1 to 2, and > 2 mm comprised 143, 79, and 35 patients, respectively. Again, no significant differences were noted in union rate or mean time to union among the groups.
CONCLUSIONS: Similar union rate and time to union were observed, regardless of nail size or CN difference. This finding indicates that most simple femoral shaft fractures can be treated with a standard, reamed 10-mm IMN. A larger nail insertion is unnecessary and presents more risks; comparatively, the use of a small nail with less reaming is simpler, requires shorter operative times, results in less blood loss, and is less expensive.
方法:本研究是对在三级创伤医疗中心接受IMN治疗的257例股骨干骨折患者的回顾性研究。所有插入的IMN均相同(StrykerT2股骨钉)。根据指甲大小将患者分为几组(10-,11-,12-,或13毫米)和CN差异(<1、1-2或>2毫米),比较了工会率和工会时间。
结果:10-,11-,12-,根据指甲大小,13毫米组有113、74、54和16名患者,分别。总体结合率为97%(257/265)。在这4组之间,未观察到愈合率或愈合时间的显着差异。基于<1-的CN差异的组,1至2毫米,>2毫米,包括143、79和35名患者,分别。再一次,各组间的工会率或平均工会时间无显著差异.
结论:观察到相似的愈合率和愈合时间,无论指甲大小或CN的差异。这一发现表明,大多数简单的股骨干骨折可以用标准的治疗,扩孔10毫米IMN。较大的指甲插入是不必要的,并且存在更多风险;相对而言,使用扩孔少的小钉子更简单,需要更短的手术时间,减少失血,而且更便宜。