交锁髓内钉治疗股骨干骨折及相关问题探讨(附106例报告)Yeatment of Femoral Shaft Fractures with Interlocking Nail
刘岩,陈庆泉,苟三怀,欧阳跃平,匡勇,叶晓健,谭军,钱齐荣,宁苏江
摘要(Abstract)：
目的:探讨使用交锁髓内钉治疗股骨干骨折的最佳手术方式选择。方法:对1998年6月～2002年10月使用交锁髓内钉治疗106例(118肢)股骨干骨折的疗效进行回顾性分析。手术采用闭合或小切口开放复位,用三维瞄准器锁定骨折远、近端。结果:平均随访14.4个月,肢体、关节功能恢复优良率95.3％,一期骨折愈合率94.0％,平均骨临床愈合时间5.7个月。2例软组织感染,感染率1.9％,2例髓内钉断裂。结论:交锁髓内钉治疗股骨干骨折应常规闭合复位、扩髓、静力固定,不强求解剖复位,本组取得了满意疗效,认为是目前治疗股骨干骨折的首选方法。
关键词(KeyWords)： 股骨骨折;交锁髓内钉;闭合复位;扩髓;静力固定
基金项目(Foundation):
作者(Author): 刘岩,陈庆泉,苟三怀,欧阳跃平,匡勇,叶晓健,谭军,钱齐荣,宁苏江
Email:
DOI:
参考文献(References)：
- (1) 马元璋,陈正中,王亦璁,等.加压髓内针内固定的动物实验与临床应用[J].中华外科杂志,1987,8:477～480．
- (2) Johnson KD, Greenberg M. Comminuted femoral shaft fractures[J]. Orthop Clin North Am, 1987, 18: 133．
- (3) Kessler SB, Hallfeldt KKJ, Perren SM, et al. The effects of reaming and intramedullary nailing on fracture healing[J]. Clin Orthop, 1986, 212: 18～25．
- (4) Wiss DA, Fleming CH, Matta JM, et al. Comminuted and rotationally unstable fractures of the femur treated with an interlocking nail[J]. Clin Orthop, 1986, 212: 35～47
- (5) Keating JF, OBrien PJ, Blachut PA, et al. Locking intramedullary nailing with and without reaming for open fractures of the tibial shaft [J]. J Bone Joint Surg (Am), 1997, 79: 334～341．
- (6) 唐杞衡.髓内钉对长骨干骨皮质血供的影响[J].中国矫形外科杂志,2001,8(4) :390～391．
- (7) Grundnes O, Reikeras O. Nailing and occlusion of the medullary cavity: Flow and mechanical changs in rat femure[J]. Acta Orthop Stand, 1994, 65(2) : 175～178．
- (8) Brumback PJ, Uwagei-Ero S, Lakatos R, et al. Intramedullary nailing of femoral shaft fractures. Part Ⅱ: Fracture-healing with stanc interlocking femoral fixation[J]. J Bone Joint Surg(Am), 1988, 70: 1453．
- (9) Wolinsky PR, McCarty E, Shyr Y, et al. Reamed intramedullary nailing of the femur: 551 cases [J]. J Trauma, 1999, 46(3) : 392～399．
- (10) Braten M, Nordby A, Terjesen T, et al. Bone loss after locked intramedullary nailing. Computed Tomography of femur and tibia in 10 cases[J]. Acta Orthop Scand, 1992, 63: 310．