109例股骨干骨折带锁髓内钉内周定术并发症及处理对策

Complications after femoral shaft fracture treated with intramedullary internocking nails and its appropriate managements

目的探讨股骨干骨折带锁髓内钉内固定术后并发症及相应处理对策，为临床更好地治疗该类疾病提供依据。方法对109例股骨干骨折患者行带锁髓内钉固定术，其中单纯股骨干骨折81例、股骨干骨折合并转子下骨折28例。结果远端锁钉失败18例（其中2枚远端锁钉未锁上1例、1枚远端锁定未锁上15例、锁定松动退出1例，断1枚锁钉1例），骨折端劈裂3例，骨折延迟愈合16例，骨不连1例，膝关节屈曲受限20例，断主钉2例。结论扩髓型带锁髓内钉治疗股骨干骨折疗效较好，但需要注意术前选钉合理、术中操作规范、术后康复及时、科学。

Objective To investigate the complications and appropriate managements. Methods 109 cases were treated with intramedullary interlocking nails. 81 cases were simple femoral shaft fratures and 28 cases were combined with subtrochanteric fractures. Results Distal nailing failure in 18 patients（2 distal nails unlocked in 1 cases, 1 nail unlocked in 15 cases,nails were loosened and exited in 1 case,1 nail breakage in 1 case）. Split of fracture en- ded in 3 cases. Delayed union in 16 cases,nonunion in 1 case. Flexion restriction of knee joint in 20 cases. Broken of main nail in 2 cases. Conclusion Using the intramedullary interlocking nails to treat femoral shaft fractures had defi- nite effect. To avoid the complications, choosing suitable nails preoperative, standard operation, timely and scientific rehabilitation postoperation are necessary.