股骨干多段骨折的治疗体会

Treatment experience on femoral shaft fractures

目的：总结股骨干多段骨折的治疗经验。方法：收治股骨干多段骨折患者6例，1例上段骨折且中间骨块无粉碎，使用交锁形髓内针固定。2例患者应用外固定支架固定，均为下段及中段粉碎性骨折。3例使用镍钛形状记忆合金材料固定，其中1例为较复杂的中下段骨折，中间骨块较长而且劈裂移位，远端骨折线近股骨髁并有游离骨片，将中间骨块先用钢丝固定为一整体，复位后将圆柱形环抱器和分体式接骨板结合固定。中段骨折1例，中间骨块较长，采用2个圆柱形环抱器固定；下段骨折1例，采用圆锥形环抱器固定；1例为中段骨折，中间骨块较短但粉碎，采用长度足够的单个圆柱形环抱器固定。结果：本组6例患者经过治疗，在3～6个月内愈合，治愈6例，治愈率100.0%。结论：交锁形髓内针、镍钛记忆合金材料及钢板结合固定、外固定支架是治疗股骨干多段骨折的有效方法。

Objective:To summarize the treatment experience on femoral shaft fractures.Methods:6 paitents with femoral shaftfractures were selected,in which there 1 cases of upper and middle bone block without crushing was treated with interlockingintramedullary nail fixation.2 cases were fixed with external fixation,whom were the lower segment and middle segmentcomminuted fracture.Another 3 were fixed with nickel titanium shape memory alloy material,including 1 case of complicateddistal fracture,bone splitting and middle long displacement,fracture of the distal femoral condyle and the free line near the bone,the middle bone fixed as a whole with wire fixation,and then fixed it with cylindrical fixator and split plate after reset;1 case ofmiddle fracture with longer middle bone block,were fixed with two cylindrical embracing fixator;1 case of lower segment fractureswere fixed with cone embracing fixator;1 case of middle bone fracture,the middle bone fragment is short but crushed,were fixedwith a single cylindrical embracing device with sufficient length.Results:After treatment,all of those 6 cases healed in 3～6months,6 cases were cured,the cure rate was 100% .Conclusion:Interlocking intramedullary nail,nickel titanium memory alloymaterial and steel plate fixation,external fixation are effective method in the treatment of femoral shaft fractures.