非透视下闭式股骨重建钉内固定治疗股骨粗隆间骨折

Without Roentgenoscopy and Close Reduction with Reconstuction Interlocking Nail to Treat Femoral Intertrochanteric Fracture

目的 探讨非透视下闭式复位股骨重建钉内固定治疗股骨粗隆间骨折的可行性。方法 将 6具成人股骨干燥骨骼标本行股骨重建钉内固定 ,主钉插入深度以主钉近端平面与大粗隆尖部相平行为基准并保持 10°前倾 ,观察股骨近端 2枚松质骨螺钉的位置。并按此法在临床应用 18例。结果 实验组 6例 ,股骨近端松质骨螺钉位置良好 ;临床应用的 18例中 ,17例股骨近端 2枚螺钉在正位X线片上位于股骨颈骨质内 ,1例螺钉穿出股骨颈骨质 ;在侧位X线片中 ,18例螺钉均位于股骨颈骨质内。经过 3～ 15个月的随访 ,平均随访 6个月 ,髋关节功能优良率 93 7%。结论 非透视下闭式股骨重建钉内固定治疗股骨粗隆间骨折的手术方法 ,具有设计合理与不用接触放射线的优点 ,值得临床推广应用。

Objective To study the feasibility without roentgenoscopy and close reduction with reconstuction interlocking nail for the treatment femoral intertrochanteric fracture.Methods Reconstuction interlocking nail fixation was taken on 6 dry adult femoral specimen,the proximal part of reconstuction interlocking nail was in parallel with the greater trochanter and the 10° anteversion,to study how to place screw into femoral neck.This technique was used in 18 the patients.Results The placement of screw into femoral neck in experimental group was well.In 18 patients,in standard anteroposterior position radiographs,17case screws were in inner femoral neck,1 case the screw penatrated femoral neck cortes.In lateral radiographs,all case screws were in inner femoral neck.Eighteen cases were followed-up with an average of 6 months during 3～15 months,the rate of excellent and good result was 93.7%.Conclusion This technique disigned was valid,without roentgenoscopy exposure,it is worthy of application in clinic.