股骨前弓与髓内钉匹配性的研究进展

Research progress concerning match between femoral anterior arch and intramedullary nail

股骨前弓是应用髓内钉固定治疗股骨转子间骨折时必须考虑的重要因素,股骨前弓的弯曲度影响股骨近端髓内钉曲率半径、长度、直径及进钉点的选择,髓内钉与股骨前弓不匹配会导致稳定性较差,以及术后大腿前方疼痛、股骨前皮质的激惹、甚至穿孔骨折。为了保证股骨转子间骨折术后的疗效,必须对股骨前弓有着充分的了解。股骨前弓的弯曲度可以用曲率半径和股骨前弓角来表示,以前者使用较为广泛。本文的目的是针对股骨前弓曲率半径相关内容及股骨前弓与髓内钉匹配性等问题,探讨髓内钉如何具有较好的稳定性,从而减少术后并发症的发生。

The femoral anterior arch is an important factor that must be considered when intramedullary nailing is used to treat a femoral intertrochanteric fracture,as its curvature decides the radius,length and diameter of the curvature of a proximal femoral intramedullary nail and selection of a proper entry point for the nail as well.Mismatch between an intramedullary nail and the femoral anterior arch can lead to poor stability,postoperative pain in the anterior thigh,irritation of the anterior femoral cortex and even a perforation fracture.In order to ensure fine curative effects for femoral intertrochanteric fractures,it is necessary to have a full understanding of the femoral anterior arch.The curvature of the femoral anterior arch can be expressed by the radius of curvature(ROC)or the angle of femoral anterior arch,with the former more widely used.This article mainly discusses the issues concerning ROC and the match between femoral anterior arch and intramedullary nail so as to clarify how an intramedullary nail can be stable enough to reduce postoperative complications.