瞄准器引导股骨交锁髓内钉远端锁钉的再认识

Understanding of distal locking in femoral intramedullary nail with matched target device

[目的]分析瞄准器引导下股骨交锁髓内钉远端锁钉困难的原因,以提高远端锁钉成功率。[方法]用配备远端瞄准器的股骨交锁髓内钉治疗股骨干骨折297例(301侧股骨),髓内钉301枚,国产钉216枚,进口钉85枚;粉碎性骨折108例,非粉碎性骨折189例;其中4例双侧股骨干骨折;均采取静力型固定,远近端各2枚锁钉。[结果]301枚股骨交锁髓内钉有288枚远端锁钉一次成功,有13枚初次锁钉未成功,一次锁钉成功率为95.7%。[结论]股骨交锁髓内钉远端锁钉困难的原因是多方面的,要提高远端锁钉一次成功率,必须重视包括术前准备在内的各个环节。

[ Objective]The reasons for distal-locking difficulty of femoral interlocking intramedullary nail with matched target device were analysed. [Method] Between Dec. 1990-May ,2004,297 cases of femoral fracture were treated with interlocking intramedullary nail guided by matched target device. Four cases out of 297 cases were bilateral fracture, they were all women, 108 cases were comminuted fracture, 189 cases were non-comminuted fracture. A total of 216 domestic nails and 85 imported nails were used. Static locking was adopted, two bolts were locked respectively at proximal and distal end. [ Result] During the operation, the first-time success of distal locking in 288 nails was gotten, hut failed in 13 cases, the rate of first-time success was 95.7%. [Condusion] Various factors existed for distal locking in femoral nail with matched target device. In order to raise the rate of first-time success for distal locking, every links during the opertion must he emphasize, including preoperative preparation.