- 期刊
Comparision of Open VS Closed Intramedullary Nailing of Femur by Utilizing Interlockiing Nail
股骨鎖定型、骨髓內釘之開放式及閉鎖式手術方法之比較
摘要
在此回顧性的研究中，我們對於股骨鎖定型骨髓內釘之開放式及閉鎖式手術方法加以比較。自1986年11月到1988年11月，台大醫院骨科共計對28位股骨粉碎型及不穩定型骨折病患施行鎖定型骨髓內釘之治療。其中有134位接受開放式的手術方法，有8位接受閉鎖式的手術方法，而另外7例則是因為前次手術失敗才來再接受鎖定型骨髓內釘之治療。在這28位病中人共有9位併發癒合延遲或未癒合；而這9位全部都是接受開放式手術的案例。有5位病人併發深部感染，其中有4位是接受開放式的手術療法，而另外一位在其接受封閉式鎖定型骨髓內釘之前已接受過一次開放式傳統骨髓內釘之手術。此外，在接受開放式手術療法中，有23.1%併發骨髓炎，38.5%併癒合延遲及15.4%併發未癒合；而在接受閉鎖式手術方法的案例都無任何此類的併發症。我們的結論是：雖然封閉式鎖定型骨髓內釘其手術方法較為困難，但由於其可以減少術後的併發症，因此還是值得採用；而開放式的骨髓內釘固定術，我們當儘可能避免使用。
關鍵字
無資料並列摘要
In a retrospective study, open intramedullary interlocking nailing of femur was compared with closed intramedullary interlocking nailing. These included twenty-eight patients with comminuted and rotational unstable fractures of femur which were treated with interlocking nailing from November 1986 through November 1988. thirteen of them had the nail inserted by the open technique; 8 patients were treated by the close technique; and of the other 7 patients, the interlocking nail was inserted as a salvage procedure for previous failed surgical intervention, 6 were open and one was closed nailing technique. Nine patients developed delayed union or nonunions, all of them had open nailing. Five patients developed deep infection, four of them were underwent open interlocking nailing; while the other one received closed interlocking nailing for previous infected open intramedullary nailing. There were 23.1% (3/13) osteomyelitis, 38.5% (5/13) delayed union and 15.4% (2/13) nonunion in the group treated by open interlocking intramedullary nailing, and no any of these complications in the closed nailing group. Our conclusion of this study were that: in spite of its technical difficulties; closed interlocking intramedullary nailing was worthwhile; and open intramedullary nailing seemed difficult to be justified.
延伸閱讀
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