Comparison Of Round Anteroposterior Hole Technique And Free-hand Technique In Distal Locking Nail Of Intramedullary Nail Treatment Of Femoral Fractures

Objective:In this research, we aimed to retrospective analysis the distal locking nail of femoral intramedullary nail in the round anteroposterior hole technique or free-hand technique in surgical treatment of femoral shaft fractures. For the treatment of femoral shaft fractures orthopedic surgeons to provide selected on the surgical solutions. Methods:For January 2012- January 2014 Jincheng Coal Industry Group General Hospital, orthopedic trauma treated 156 cases of femoral shaft fracture patients(patients met the following criteria:Age ≧20 years old and ≦70-year-old, needs surgery treatment with intramedullary nail, and distal locking failure, needs use the above-mentioned technique), were retrospectively analyzed. The patients were divided into two groups: A group of 75 cases, the round anteroposterior hole technique was used; group B of 81 cases, the free-hand locking technique was used. To compare the following items: the time of the two distal locking nails(from the intramedullary mail nail fixing into intramedullary space, from confirming the failure of the first pressing the rod, perspective began to confirm the position of the second piece of good distal locking screw up), the success rate of one-time and photograph times of locking. Refer to Lysholm knee system, the standard of fracture heeling time and postoperative follow-up evaluation, comparing the function of thigh of patients with intramedullary nail treatment. Result:For all 156 cases, including 120 male cases and 36 female cases, the patients femoral intramedullary nail fixation were analyzed, remote locking nail two successful time: A group of 13.769?2.4925 min, group B 25.652?7.4182 min, the difference was statistically significant(P <0.05); disposable locking success rate: A group of 72 cases of distal locking is successful, three cases of distal locking failure, the success rate of the remote locking nail is 96%. Group B 50 cases remote locking is successful, 30 cases of distal locking is successful, the success rate of the remote locking nail is 62%, the difference was statistically significant(P<0.05); A group of distal locking nail photograph intraoperative photograph time 4.95?1.881 sec(range 3-11 seconds). B group average intraoperative photograph time 23.28?8.274 sec(range 10–52 seconds), the difference was statistically significant(P <0.05); follow-up period from 4 months to 10 months, fracture healing time: A group(6.52?1.588) months, B group(6.74?1.909)months, the difference was not statistically significant(P> 0.05); Lysholm rated excellent rate: A group 94.7%, B group 96.3%, the difference was not statistically significant(P> 0.05). Conclusion:Two kinds of intramedullary distal nailing of femoral shaft fracture treatment methods have achieved a good cure rate and long-term treatment. The round anteroposterior hole technique in the treatment of femoral bone and free-hand locking intramedullary nail comparison: 1) the round anteroposterior hole technique to distal nail locking intramedullary nail, more easy operation, more accuracy intraoperative positioning, significantly improves the remote locking success rate of the nails; 2) the round anteroposterior hole technique in the intramedullary nail distal locking screws, reducing the number of C-arm X-ray continuous photograph, reducing radiation damage to doctors and patients; 3) the round anteroposterior hole technique improvements to reduce the number of femoral punch when remote locking, reduce patient surgical trauma, easy to heal the wound, reflecting the minimally invasive principle. So, the round anteroposterior hole technique has a more broad application prospects, and it should be vigorously promoted.