改良带刃弧形梅花针治疗股骨下段骨折

Modified arc intramedullary nail for treatment of fractures of the distal femoral shaft

目的 探讨改良带刃弧形梅花针内固定治疗股骨下段骨折的临床疗效及优点。 方法 在观察和测量国人尸体股骨及其髓腔形态的基础上 ,设计出带刃弧形梅花针治疗股骨下段骨折的术式。临床治疗 32例 ,其中男 2 5例 ,女 7例 ;年龄 8～ 6 8岁 ,平均 2 7岁。 结果 术后平均随访 2 2个月 (8～ 72个月 ) ,32例骨折全部愈合 ,其中 1例延迟愈合。骨折临床愈合时间 6～ 14周 ,平均 10周 ,无弯针、断针、松动、骨感染、骨折不愈合、畸形愈合及再骨折发生。按Kolmert等功能评定标准 ,优 2 3例 ,良 7例 ,可 2例 ,优良率 93.8%。 结论 本法治疗股骨中下段骨折符合解剖学及生物力学要求 ,手术创伤小 ,操作简便 ;术中不需X线机监视 ,固定较牢固 ,膝关节可早期功能锻炼 。

Objective To study the clinical effects and advantages of modified arc intramedullary nail(MAIN) for the treatment of the fracture of distal femoral shaft. Methods Based on the study of the morphology of the intramedullary canal of the femur, The authors designed a modified arc intramedullary nail for the treatment of fracture of the distal femoral shaft. From June 1993 to January 2000, 32 case of distal fracture of the femur were treated by MAIN. Results The average duration of follow-up was 22 months (8～72 months). All patients achieved solid bone union, no nail breaking, infection, nonunion, or refracture occurred. According to Kolmert's criteria, the total excellent and good rate was 93.8%. Conclusions The MAIN is designed according to the anatomical character and the biomechanical principle of human distal femur. It can provide a stable fixation and allow early exercises. With the advantages of easy manipulate, less complications, unnecessary for X-ray monitoring during the procedure, it is a good method for the fractures of the distal femoral shaft.