带锁髓内钉内固定术治疗股骨干骨折的并发症及处理

Analysis and Handling of Complications After Femoral Shaft Fracture Treated with Intramedullary Internocking Nails

【目的】探讨带锁髓内钉治疗股骨干骨折(FSF)的术后并发症及相应处理对策。【方法】对97例FSF患者行带锁髓内钉内固定术,其中单纯FSF 89例、FSF合并粗隆下骨折8例。【结果】本组发生锁钉失败5例(其中1枚远端锁钉未锁上4例、锁钉松动退出1例)、骨折端劈裂1例、骨折延迟愈合3例、骨不连1例、膝关节屈曲受限7例。【结论】扩髓型带锁髓内钉治疗FSF应注意术前选钉合理、术中操作规范、术后采用及时科学的康复措施有利于降低并发症的发生。

[Objective]A retrospective analysis was conducted on 97 cases of femoral shaft fratures（FSF） treated with intramedullary interlocking nails , to investigate the complications and appropriate managements. [Methods]Patients with FSF were treated with intramedullary interlocking nails. Eighty nine cases were simple FSF and 8 cases were combined with subtrochanteric fractures. [Results]Distal nailing failure occurred in 5 patients（ 1 nail unlocked in 4 cases, nails were loosened and exited in 1 case）, Split of fracture end happened in 1 case. Delayed union occurred in 3 cases, nonunion in 1 case. Flexion restriction of knee joint occurred in 7 cases. [Conclusion]To avoid the complications with intramedullary interlocking nails to treat FSF, choosing suitable nails preoperatively,intraoperative standard technique and postoperative scientific rehabilitation are necessary.