重建交锁髓内钉治疗复杂多段股骨骨折疗效观察

Treatment of complex multiple segment fracture of femur with femoral reconstruction nail

目的:探讨重建型交锁髓内钉治疗复杂多段股骨骨折的手术方法及注意事项。方法:使用重建型交锁髓内钉对58例合并股骨颈/干骨折、股骨粗隆下粉碎性骨折、股骨干严重的粉碎性骨折进行内固定治疗,闭合或开放穿钉。结果:58例病人随访6～24个月,愈合时间5～12个月,平均6.8个月,优良率达94%以上。均无伤后感染、肺炎、断钉等并发症的发生。结论:颈干交锁,该钉保持了正常的颈干角,通过髓腔中央承受压力传导。将整个固定系统与股骨头、颈、干构成一相对完整牢固的整体。可早期负重,功能锻炼,有利于骨折愈合。重建交锁髓内钉是治疗复杂股骨骨折的理想方法。

Objective：To investigate the clinical effect of femoral reconstruction nail in the treatment of complex multiple segment fracture of femur.Methods：The internal fixation of closed or open intramedullary nailing was performed in 58 patients with femoral neck fracture accompanied by femoral shaft fracture, subtrochanteric comminuted fracture of femur and severe comminuted fracture of femoral shaft with reconstruction interlocking intrameduUary nail.Results：All 58 cases were followed up for 6-24 months, the healing time was 5- 12 months with an average of 6.8 months,the excellent and good rate was 94% or more.There was no serious complication in this group such as infection ,pneumonia, nail breaking and so on.Conclnsion： Reconstruction the neck and shaft of femur,this nail kept the normal angle of neck and shaft of femur,and bore the pressure conduction through the center of marrow cavity.A relative intact and firm whole body consisted of whole fixed system and head,neck and shaft of femur,and could bear weight and functional exercise early,it was advantageous to the healing of fracture.Reconstruction interlocking intramedullary nail was an ideal way in the treatment of complex femoral fracture.