目前老年股骨转子间骨折的治疗,头髓钉固定已成主流手术方式。除亚洲型股骨近端防旋髓内钉(proximal femoral nail anti-rotation-Ⅱ,PFNA-Ⅱ)外,头髓钉的主钉尾部都含有内锁螺钉。内锁螺钉的初始作用是防止头颈内置物的旋转,术中是否...目前老年股骨转子间骨折的治疗,头髓钉固定已成主流手术方式。除亚洲型股骨近端防旋髓内钉(proximal femoral nail anti-rotation-Ⅱ,PFNA-Ⅱ)外,头髓钉的主钉尾部都含有内锁螺钉。内锁螺钉的初始作用是防止头颈内置物的旋转,术中是否拧牢内锁螺钉,从而阻止或保留头颈内置物的滑动,临床上有不少争议。本文通过查阅文献和各种头髓钉说明书,从内锁螺钉的历史、种类、临床应用及使用争议等方面进行总结分析,以期取得内锁螺钉使用共识,为提高股骨转子间骨折固定疗效提供参考。展开更多
Breakage of locking bolts is an important cause of interlocking nail failure in femoral fractures. It usually occurs in the form of single breakage in one of the distal bolts of the nail or nail breakage around the di...Breakage of locking bolts is an important cause of interlocking nail failure in femoral fractures. It usually occurs in the form of single breakage in one of the distal bolts of the nail or nail breakage around the distal locking hole. Here we report an unusual ease ofintramedullary femoral nail failure with segmental breakage of both the distal locking bolts. Such a scenario usually complicates further management. We successfully managed this casewith exchange nailing without bone grafting. Here we briefly reviewed the literature regarding such an unusual presentation and discussed in detail the possible etiology of such a presentation and the management options when facing such a complex situation.展开更多
文摘目前老年股骨转子间骨折的治疗,头髓钉固定已成主流手术方式。除亚洲型股骨近端防旋髓内钉(proximal femoral nail anti-rotation-Ⅱ,PFNA-Ⅱ)外,头髓钉的主钉尾部都含有内锁螺钉。内锁螺钉的初始作用是防止头颈内置物的旋转,术中是否拧牢内锁螺钉,从而阻止或保留头颈内置物的滑动,临床上有不少争议。本文通过查阅文献和各种头髓钉说明书,从内锁螺钉的历史、种类、临床应用及使用争议等方面进行总结分析,以期取得内锁螺钉使用共识,为提高股骨转子间骨折固定疗效提供参考。
文摘Breakage of locking bolts is an important cause of interlocking nail failure in femoral fractures. It usually occurs in the form of single breakage in one of the distal bolts of the nail or nail breakage around the distal locking hole. Here we report an unusual ease ofintramedullary femoral nail failure with segmental breakage of both the distal locking bolts. Such a scenario usually complicates further management. We successfully managed this casewith exchange nailing without bone grafting. Here we briefly reviewed the literature regarding such an unusual presentation and discussed in detail the possible etiology of such a presentation and the management options when facing such a complex situation.
