Abstract:Objective: To investigate the effect of single butterfly fracture fragment on the healing of femoral shaft fracture treated with intramedullary nail. Methods: From February 2010 to February 2016, 72 patients with closed femoral comminuted fracture admitted to Xuzhou Medical University Affiliated Hospital of Lianyungang, including 46 males and 26 females, with an average age of 38 (17-64 years old), 40 cases on the right side, and 32 cases on the left side. All patients were treated with femoral interlocking intramedullary nail. According to femoral shaft diameter, the displacement degree of butterfly fracture was divided into four degrees: Ⅰdegree (displacement was less than 1/3 of shaft diameter): 41 cases; Ⅱdegree (displacement was greater than 1/3 of the diameter and less than 2/3): 17 cases; Ⅲdegree (displacement was greater than 2/3 of the diameter): 9 cases; Ⅳdegree (fracture fragment turnover): 5 cases. According to RUSF score, fracture healing rate and average time of fracture healing, the effect of displacement degree of fracture fragment on fracture healing was evaluated. Results: All the indexes of the 4 groups were statistically significant. The fracture healing was best in the group ofⅠdegree displacement, with the fracture healing rate of 87.8% and the average healing time of 4.8 months. The patients withⅢdegree displacement andⅣdegree displacement had the worst healing, and the healing rate was 22.2% and 20.0%, respectively, with an average healing time of 12.6 months and 18 months. The patients withⅡdegree displacement had the healing rate of 64.7% and the average healing time of 8.9 months. Conclusion: The butterfly fracture withⅠdegree displacement needs no intervention, the fracture withⅣdegree displacement should be restored and as close to the bone defect as possible to avoid nonunion, andⅡdegree andⅢdegree displaced fragments should be given closed reduction to withinⅠdegree displacement as far as possible to minimize the incidence of nonunion.
