股骨转子间骨折行股骨近端髓内钉内固定术后旋转畸形的临床评估

Clinical assessment of femoral malrotation following intramedullary nailing of the femur intertrochanric fractures with proximal femoral nails

目的分析股骨近端髓内钉(PFN)内固定治疗股骨转子间骨折术后发生旋转畸形的原因,探讨预防措施。方法对26例单一股骨转子间骨折患者应用PFN钉治疗。术后CT扫描成像获得相关测量数据,评估骨折远近端旋转畸形的程度,分析术后发生旋转对线不良的原因并进行临床评估。结果 26例患者均得到门诊随访,时间12～36个月。7例患者(26.9%)术后有15°以上旋转畸形。结论应用PFN髓内固定治疗股骨转子间骨折,术中操作不规范和复位不理想是发生旋转畸形的主要原因。精细操作、良好复位可减少旋转畸形的发生,改善术后关节功能。

Objective To analyze cause for postoperative femoral malrotation after treatment of the femur intertrochanteric fractures with proximal femoral nails.Methods An retrospective study was done on 26 patients with intertrochanteric fracture treated with proximal femoral nail（PFN）.The cause for postoperative malalignment were analyzed through the CT-scanzed method.Results All patients were followed up for 12～36 months.Of all,7 patients（26.9%） had rotational deformities beyond 15°.Conclusions Treatment of the femur intertrochanteric fracture with PFN can lead to malalignment of femur to some extent.Irregular performance and bad reduction are the important causes which lead to malrotation of femur.To avoid its development requires good qualities of reduction.Intraoperatively careful attetion to details is important to reduce malalignment of femur and to improve function of hip.