Treatment of femoral shaft fracture with lateral traction frame closed reduction and intramedullary nail fixation / 中国组织工程研究

ABSTRACT

BACKGROUND: At present, there are relatively few studies on the closed reduction of intramedullary nail treatment for femoral shaft fractures. OBJECTIVE: To investigate the effect of closed reduction and intramedullary nailing in the treatment of femoral shaft fractures in the lateral position. METHODS: From January 2015 to October 2018, 54 patients with femoral shaft fractures were treated with intramedullary nailing at Department of Orthopedics and Traumatology, the Third Affiliated Hospital of Zunyi Medical University. The patients were randomly assigned to three groups, including 17 cases in the supine mechanical traction group, 17 cases in the lateral artificial traction group, and 20 cases in the lateral mechanical traction group. All patients signed the informed consent. This study was approved by the Hospital Ethics Committee. Closed reduction success rate, operation time, intraoperative blood loss, fracture healing time, and hospital for special surgery knee score at 6 months after surgery were compared in the three groups. RESULTS AND CONCLUSION: (1) All patients were followed up for 6 to 15 months. (2) The success rate of fracture closure was 100% in the lateral mechanical traction group, 82% in the lateral artificial traction group, and 59% in the supine mechanical traction group. There was no significant difference between supine mechanical traction group and lateral artificial traction group (P > 0.05). The success rate was significantly higher in the lateral mechanical traction group than in the supine mechanical traction group (P=0.002). There was no significant difference between the lateral mechanical traction group and the lateral artificial traction group (P > 0.05). (3) No significant difference was found in operation time between the supine mechanical traction group and the lateral artificial traction group (P > 0.05). The operation time was significantly shorter in the lateral mechanical traction group than in the supine mechanical traction group and lateral artificial traction group (P 0.05). (5) Fracture healing time was significantly longer in the supine mechanical traction group than in the lateral artificial traction group (P=0.030) and lateral mechanical traction group (P 0.05). (6) No significant difference in hospital for special surgery knee score at 6 months after surgery was detected among the three groups (P > 0.05). (7) These results suggested that application of lateral recumbent traction frame closure and intramedullary nailing for the treatment of femoral shaft fractures has the advantages of high success rate, short operation time, less intraoperative blood loss and short fracture healing time. It is worthy of clinical application.