动力髁螺钉或股骨近端髓内钉治疗股骨干骨折合并同侧股骨颈或转子间骨折的评价

Realization of the operative treatment for 35 cases of femoral shaft fractures with ipsilateral femoral neck or intertrochanteric fractures

目的观察动力髁螺钉(DCS)、近端股骨髓内钉(PFN)治疗股骨干骨折合并同侧股骨颈及转子间骨折的临床疗效。方法采用内固定方式治疗35例股骨干骨折合并同侧股骨颈或转子间骨折,其中股骨干合并同侧股骨颈骨折10例,合并转子间骨折25例,使用DCS固定9例,使用PFN固定26例。结果随访时间6～30个月,平均18个月,33例骨折愈合、患肢关节功能优良,2例出现股骨头坏死,愈合率为94%,不愈合率为6%。结论对于股骨干骨折合并同侧股骨颈或转子间的复杂骨折,选择采用DCS或PFN治疗,DCS适用于较稳定的骨折,PFN有手术时间短,组织损伤小的优点。两者均具有在骨折愈合、功能恢复和早期活动方面均较满意的效果。

Objective To conclude the treatment of femoral shaft fractures with ipsilateral femoral neck or intertrochanteric fractures by dynamic condlar screw（DCS） and proximal femoral nail（PFN）. Methods From January 1998 to June 2005,35 patients of femoral shaft fractures were studied. 10 patients were associated with ipsilateral femoral neck fractures,25 patients with ipsilateral intertrochanteric fractures. 9 cases were treated with DCS-26 cases were treated with PFN. Results The follow-up ranged from 6 to 30 months with an average of 18 months. All the fractures healed up well except that 2 cases happened with ischemic femoral necrosis. The rate fractures healing was 94 %. Conclusion ~ is an ideal method to treat stable fractures. PFN is excellent in less invasion and shorten operation time. DCS and PFN have obvious advantages of reliable fixation short, clinical healing time and post-operative restored function.