股骨髁上逆向交锁髓内钉在股骨远端骨折中的应用

Application of intramedullary supracondylar nail in the treatment of distal femoral fracture

目的介绍用股骨髁上逆向交锁髓内钉治疗股骨远端骨折的方法与优点。方法应用股骨髁上逆向交锁髓内钉治疗２９例患者（３０个股骨）。新鲜粉碎性骨折采用Ⅰ期植骨，陈旧性骨折合并膝关节僵硬者同时行膝关节粘连松解术。结果２９例均随访６个月以上，骨折愈合时间３～１４个月（平均６个月）。按Ｋｏｌｍｅｒｔ功能评定标准，优良２６例（８９７％），一般２例（６９％），差１例（３４％）。结论股骨髁上逆向交锁钉的应用扩大了髓内钉手术适应证，具有操作简便、固定牢靠、锁钉定位准确等优点，是治疗股骨远端骨折的有效方法。

Objective To introduce our clinical experience in applications of intramedullary supracondylar (IMSC) nail in the treatment of distal femoral fracture Methods 29 cases of the distal femoral fractures (30 femora) were treated with IMSC nail which were inserted retrograde the intercondylar notch of distal femur. The primary bone grafting was performed for fresh comminuted fractures while arthrolysis was done simultaneously in every old fracture with knee stiffness. Results 29 cases were followed up for more than 6 months and all fractures united 3 to 14 months (mean 6 months) after operation. The evaluation of the results by Kolmerts functional rating scale revealed good and excellent in 26 cases (897%), fair in two (69%) and poor in one (34%). No complications such as infection and nail break were noted in this group. Conclusion The use of supracondylar nail has widened indications of intramedullary nailing, presented with the advantages of simple performance, solid fixation and accurate screw location, and therefore become an effective therapy for distal femoral fracture.