带锁髓内钉治疗股骨粗隆下粉碎性骨折

comminuted subtrochanteric fractures of the femur treated with inter-locking intramedullary nail

目的探讨应用带锁髓内钉治疗股骨粗隆下粉碎性骨折的方法和疗效。方法 2006年1月～2009年12月应用带锁髓内钉治疗股骨粗隆下粉碎性骨折32例,其中应用普通带锁髓内钉或股骨近端长重建钉股骨模式18例,应用股骨近端长重建钉14例,闭合穿钉22例,有限切开穿钉10例。结果术后随访6～24个月,平均12个月,3例术后分别存在不同程度外旋或内翻畸形,其中1例外旋畸形经手术重新校正,1例股骨颈内螺钉松动退出1例股骨颈内螺钉切割出股骨头,均予皮牵引制动在骨折初步愈合后手术取出,未出现深部感染,全部骨折均愈合,平均愈合时间4.5个月。应用Harris髋部功能评分评定:优22例,良8例,可2例,优良率94%。结论应用带锁髓内钉治疗股骨粗隆下粉碎性骨折创伤小、固定牢固可靠、愈合率高,是治疗股骨粗隆下粉碎性骨折的有效方法。

Objective To explore the clinical application and results of inter-locking intramedullary nail in treating comminuted subtrochanteric fractures of the femur.Methods 32 cases of comminuted subtrochanteric fractures of the femur were treated using inter-locking intramedullary nail in the period from January 2006 to December 2009.There were 18 cases using general intramedullary nail or femur mode of long reconstruction nail,14 cases using long reconstruction nail.22 cases used closed reduction and 10 cases used open reduction.Results The follow up period ranged from 6 to 24 months with an average of 12 months.All the cases were obtained ideal union with an average healing time of 4.5 months.According to the criteria of Harris score,there were 22 cases assessed as excellent,8 cases as good and 2 case as medium.Conclusion Treatment of comminuted femur subtrochanteric fractures with inter-locking intramedullary nail has the advantages such as less invasion、firmed and hight healing rate,which is an ideal method.