背景:股骨钉固定后的骨折间隙会增加延迟和不愈合发展的风险。已经描述了一种用于减小股骨钉间隙的前向技术,但其疗效和治疗后果尚未在比较研究中进行研究。我们提供了一项比较研究的结果,该研究调查了前瞻技术在剩余骨折间隙和手术结果方面的疗效。
方法:在2017年至2022年之间,对193名骨骼成熟患者进行了回顾性队列研究,这些患者获得了闭合性股骨干骨折的扩髓股骨钉。残余裂缝间隙的比较,工会的时机,80例(41.45%)行前向击骨髓内钉和113例(58.55%)传统髓内钉的并发症和再次手术率,伴随着最少的1年随访。此外,比较了应用前向打击程序前后断裂间隙之间的电位差。
结果:两组年龄相似,性别,糖尿病的存在,吸烟状况,体重指数和手术时间。然而,前瞻组的术后并发症发生率明显较低,包括延迟,骨不连,以及重新手术的需要。相反,在愈合时间上没有发现显著差异(p=0.222).前击手术可将残余骨折间隙从3.99mm显著减小至1.66mm(p<0.001)。前击组未观察到包括骨不连在内的主要并发症。
结论:这项研究表明,前击技术可有效减少股骨钉固定过程中的残余骨折间隙。该技术不仅可以容易地执行,而且是可再现的。此外,它可以降低延迟工会的风险,不愈合,避免了重新手术的必要性。
方法:三级,回顾性队列研究。
BACKGROUND: A persistent fracture gap following femoral nailing increases the risk of delayed and nonunion development. A forward-striking technique for reducing the gap in femoral nailing has been described, but its efficacy and therapeutic consequences have not been investigated in comparative studies. We provide the results of a comparative study that investigated the forward-striking technique\'s efficacy in terms of remaining fracture gaps and surgical outcomes.
METHODS: Between 2017 and 2022, a retrospective cohort study was undertaken on 193 skeletal mature patients obtaining reamed femoral nailing for closed femoral shaft fractures. Comparisons of residual fracture gaps, timing to union, complications and re-operation rates were made between 80 patients (41.45%) undergoing femoral nailing with the forward striking procedure and 113 patients (58.55%) undergoing traditional nailing, accompanied by minimal 1-year follow-ups. In addition, the potential difference between fracture gaps before and after applying the forward striking procedure was compared.
RESULTS: Both groups had similar age, sex, presence of diabetes, smoking status, body mass index and time to surgery. However, the forward-striking group demonstrated significantly lower rates of postoperative complications, including delayed, nonunion, and the need for re-operation. Conversely, no significant differences were found in time to union (p = 0.222). The forward-striking procedure can significantly reduce residual fracture gaps from 3.99 to 1.66 mm (p < 0.001). No major complications in the forward-striking group including nonunion were observed.
CONCLUSIONS: This study suggests that the forward-striking technique effectively reduces residual fracture gap during femoral nailing. The technique not only could be easily performed but is also reproducible. In addition, it can lower the risk of delayed union, nonunion and obviates the necessity for re-operation.
METHODS: Level III, retrospective cohort study.