带锁髓内钉治疗股骨干骨折与远端安锁定位装置

Treatment of femoral shaft fracture with intramedullary interlocking nail and distal locking localization device

目的 总结带锁髓内钉治疗股骨干骨折的临床经验 ,改进远端锁钉瞄准器。方法 股骨干骨折 32例中 ,新鲜骨折 2 5例 ,陈旧性骨折 7例。采用闭合穿钉治疗 11例 ,半开放穿钉 12例 ,开放穿钉 9例。设制髓内钉定位孔及安锁定位装置。结果 本组病例随访 6～ 2 3个月 ,平均 12个月骨折均已愈合。按Klemm功能恢复分级评定 :优 2 1例 ,良 9例 ,中 2例。远端锁钉瞄准器改进后手术使用 30例 ,无锁钉放置失败 ,一次交锁成功 2 9例。结论 ①应用带锁髓内钉固定 ,对闭合复位困难的股骨干新鲜骨折 ,采用半开放穿钉术 ,效果良好。②改进后的远端锁钉瞄准器无需X线引导 ,锁钉准确可靠。

Objective To sum up the clinical experience of treatment of femoral shaft fracture with intramedullary interlocking nail and the distal locking device localization Methods 32 coases of femoral shaft fractures composing of 25 cases fresh and 7 old were included in this study.There were 11 cases treated by closed nailing technique,12 by half open nailing,9 by open nailing.The localization aid in the distal locking device of interlocking nail was designed.Results In the followed up of 6 to 23 months,all fractures healed.According to the criteria of Klemm,there were 21 assessed as excellent,9 as good and 2 as fair.The improved distal locking localization device was used in 30 cases operations without miss insertion distal screw in all.The first screwing was successful in 29 cases.Conclusion ①Good results have been achieved by half open nailing technique for the femoral shaft fractures which is too difficult to deal with closed reduction.②The improved distal locking localization device was screwed in accurately without X-ray guidance.