带锁髓内钉治疗股骨干骨折并发症及防治

Complication and its Prevention during the Treatment of Femoral Shaft Fracture with Interlocking Intramedullary Nail

目的:为提高带锁體内钉治疗骨折效果,作者总结了1988年7月～1997年10月用C-K钉治疗的80例股骨干骨折。材料与方法:男60例,女20例,左侧股骨41个,右侧股骨40个,平均年龄33岁(15～79岁)。结果:随访半年以上60例,骨折全部愈合。适应证选择不当造成内固定失败1例,术中再骨折2例,近端锁钉未穿过锁钉孔2例,远端锁钉放置失败3例。术后肢体延长2例,膝外翻2例,伤口深部感染1例,迟发性感染1例,主钉断裂3例,近端锁钉断裂1例,远端锁钉断裂1例,退出2例。结论:用带锁髓内钉治疗股骨干骨折,应注意:(1)严格掌握适应证。(2)C-K钉的使用需要专门的操作技术,要严格按规程操作。(3)陈旧性或粉碎性骨折应适当延迟负重时间。

Objective: In order to popularize the use of interlocking nail, the authors reviewed 81 femoral shaft fractures in 80 patients who were treated with interlocking nail from July 1988 to October 1997. Material and Method: There are 60 males and 20 females. Forty-one fractures were of left femur and 40 of right. The average age was 33 years(range 15-79 years) . Results: The results showed that 60 cases of fractures that followed up over half a year had bony union. The complications included one bone union failure due to incorrect indication. two fractures during the operation, misinserting the proximal screw in 2, and misinserting the distal screw in 3, lengthening of the extremity in 2, valgus knee in 2, deep infection in 1, delayed infection in 1, nail broken in 3, proximal screw broken in 1, distal screw broken in 1, distal screw loosening in 2. Conclusion: 1) The indication must be correctly chosen. 2) Well-trained operative technique for interlocking nail is necessary to reduce the compli cation. 3 )The patient with old or comminuted fracture fixed with G - K nail should properly delay the time to start weight bearing.