带锁髓内钉治疗钢板内固定失败后的股骨干骨折

The treatment of fracture of femoral shaft with failed internal plate fixation by using intramedullary interlocking nail

目的探讨股骨干骨折钢板固定失败后使用带锁髓内钉治疗的方法。方法1997年3月～2004年3月,采用远近端具有瞄准锁定功能的带锁髓内钉治疗股骨下段骨折钢板固定失败患者16例,均为男性,年龄29～46岁,平均年龄38岁。骨折类型:横行骨折3例,粉碎性骨折13例。发现钢板失效的时间:2周～12个月,钢板失败折断变位5例,螺钉松动拨出、钢板及骨折变位11例。结果随访10～30个月,骨折对位对线均良好,有10例于术后18个月骨折愈合取出髓内钉,余患者骨折处骨痂生长良好,骨折线模糊。膝关节功能满意。无髓内钉及锁钉断裂。结论股骨干骨折钢板内固定失败后采用带锁髓内钉固定是一种有效的补救方法,它具有固定确切牢固,创伤小等优点。

Objective To study the treatment of femoral shaft fracture with failed internal plate fixation by using intramedullary interlocking nail（IIN）. Methods Between May 3,1997 and May 3,2004 cases of femoral shaft fracture with failed internal plate fixation were treated by using IIN. All of them were males with average age of 38（range from 29 to 46）. 13 cases were comminuted fractures and 3 was transversal fractures. The time of detecting the failure of interal-plate-fixed femoral shaft fractures was between 2 weeks and 12 months after operation. 5 cases suffered plate breaking, 11 cases screws loosening or plate and fractures displacing. Results The follow-up ranged from 10 to 30 months. X-ray film revealed good fracture line and reduction. The fractures of knee joint were satisfactory in all of the patients. Conclusion IIN was an effective method for the treatment of femoral shaft fracture with failed internal plate fixation.