股骨重建髓内钉治疗不稳定性股骨粗隆下骨折的体会

Effect of Reconstruction Intramedullary Nail in Treatment of Unstable Subtrochanteric Femoral Fracture

目的探讨股骨重建髓内钉内固定治疗不稳定性股骨粗隆下骨折的临床疗效。方法对2010年5月至2017年2月采用股骨重建髓内钉治疗的30例不稳定型股骨粗隆下骨折患者进行回顾性分析,其中男23例,女7例;年龄20~46岁;病程1~3d;按Seinsheimer分类:ⅢA型15例,Ⅳ型14例,Ⅴ型1例。30例患者均为外伤致患侧髋部疼痛、肿胀,X线片证实股骨粗隆下骨折。结果30例患者均获随访,时间18~26个月,所有患者于术后12~16周达到骨性愈合,至随访结束时,未发生1例并发症。Sanders髋关节功能评分为46~60分,其中优25例,良5例。结论股骨重建髓内钉生物力学稳定性好,是治疗青壮年不稳定性股骨粗隆下骨折有效的手段。

Objective To investigate the clinical effects of reconstruction intramedullary nail in treatment of unstable subtrochanteric femoral fracture.Methods From May 2010 to February 2017,30 cases of unstable subtrochanteric femoral fracture treated with femoral reconstruction intramedullary nail with clinical course from 1 to 3 days were retrospectively analyzed.There were 23 males and 7 females,aged from 20 to 46 years old,the fractures were classified to typeⅢwith 15 cases,typeⅣwith one cases.All fracture were caused by injury,leading pain and swelling.Subtrochanteric femoral fracture was confirmed by X-ray films examination.Results Patients were followed up for 18~26 months,and fracture healing time was 12~16 months,with Sanders score of 46~60.The treatment outcome were 25 excellent cases,5 good cases.At the end of following up,there was no postoperative complication.Conclusion Femoral reconstruction intramedullary nail for treatment of subtrochanteric femoral fracture was an effective method with an good biomechanical stability.