带锁髓内钉固定并植骨治疗股骨干粉碎性骨折的疗效观察

To Study of the Treatment of Comminuted Fracture of Femoral Shaftwith Interlocking Intramedullary Nailing and Bone Grafting

目的 :探讨带锁髓内钉治疗股骨干粉碎性骨折的临床疗效和优点。方法 :回顾性分析自 1996年 4月～ 2 0 0 3年 6月股骨干粉碎性骨折 78例 ,采用有限切口切开复位 ,带锁髓内钉扩髓 ,静力型固定骨折端并植骨。根据骨折部位生长情况改为动力型固定。结果 :5 6例获得随访 ,随访 5～ 10月 (平均 7 5个月 ) ,所有病例 6～ 9个月内达到临床愈合。临近关节功能达正常 ,无感染、断钉等并发症。结论 :带锁髓内钉静力固定能有效控制骨折处的剪应力 ,同时对骨折有一定的加压作用 ,可提供早期坚强的内固定 ,骨折愈合快 ,并发症少 ,是治疗股骨干粉碎性骨折的理想方法。

Objective： To discuss the efficacy and the advantages of the treatment of comminuted fraeture of femur shaft with interlocking inmnnedullary nailing and bone graliing. Methods： Since April 1996 to June 2003, 78 cases of conuninuted femur fmctrure were reduced to anatomic appcectionby a limited open manipulation and static fixation with intramedullary interlocking nails, lntramedullary interlocking nails were placed with bone grafting after marrow cavity, was reamed. Results： Fifty- six cases were followed-up from 5 alonths to 10 months （average 7.5 months）, and all cases achieved a clinical union within 6 - 9 nlonths, and all healed up well and there were no complieation in this series. Conclusion： Not only intramedullary interlocking nails ean produce rigid fixation and effectively control harmnful shearing stress, but also has some pressor function. It can provide firm internal fixation, accelerate fraeture healing and fewer eolnplications. So it is a perfect procedure for patients with comminuted fracture of femoral shaft.