摘要
目的探讨闭合复位带锁髓内针内固定治疗粉碎股骨干骨折术中旋转及成角畸形的预防。方法自2001年4月～2003年6月应用闭合复位带锁髓内针内固定治疗粉碎性股骨干骨折50例,术中采用骨科牵引床和C型臂X线机透视。采用髋、膝、踝关节中点连线为下肢轴线,测量中立位双侧股骨颈、股骨髁、小转子到股骨皮质投影的长度,健侧及患侧一致后锁死锁钉。术后CT扫描测量股骨前倾角了解旋转畸形程度,摄骨盆平片测量颈干角。结果患侧组前倾角值为(14.98°±10.26°),最大值为34.26°,最小值为-5.00°,健侧组前倾角值为(12.98°±1086°),最大值为32.20°,最小值为-4.60°,使用配对资料t检验,P>0.05,差异无非常显著性的意义。患侧组颈干角值为(128.44°±11.24°),最大值为137.36°,最小值为109.12°。健侧组颈干角值为(129.98°±10.66°),最大值为134.36°,最小值为112.26°。P>0.05,差异无非常显著性的意义。结论股骨干骨折采取闭合复位带锁髓内针治疗,术中应在影像监视器监控下以髋、膝、踝关节中点为下肢轴线,测量中立位双侧股骨颈、股骨髁、小转子到股骨皮质投影的长度可预防股骨旋转及成角畸形。
Objective To investigate the prevention of rotation and angulation in the treatment of the comminuted fracture of the femoral shaft with closed reduction and intramedullary locking nail. Methods Fifty cases of severe femoral shaft fracture were treated with close reduction and intramedullary locking nail from April 2001 to June 2003. During operation, the center of hip, the knee and ankle joint were used as the axis of lower extremities. The projection length of femoral neck, lesser trochanter and femoral condyles of both sides were measured in neutral position. When the length of both sides was same, the intramedullary nail was locked. After the operation the CT scanning was performed and X - ray was taken to measure the neck- shaft angle and the anteversion angle. Results The maximum anteversion of the fracture side was 34.26° and the minimum was - 5.00° with the mean value （14.98° ± 10.26°） while the maximum anteversion of the contralateral side was 32.20° and the minimum was - 4.60°with the mean value （12.98° ± 10 86°） （P 〉 0.05）. The maximum neck- shaft angle of the fracture side was 137.36°and the minimum was 109.12° with the mean value （128.44°± 11.24°） while the maximum neck-shaft angle of the contralateral side was 134.36°and the minimum was 112.26° with the mean value （129.98° ± 10.66°） （P 〉 0.05）. The difference was not significant. Conclusion The center of hip, knee and ankle joint should be used as the axis of lower extremities and the projection length of femoral neck, lesser trochanter and femoral condyles of both sides should be measured under the imaging monitoring intra- operatively, which will prevent rotation and angulation in the treatment of the fracture of the femoral shaft with closed reduction and intramedullary locking nail.
出处
《中国骨与关节损伤杂志》
2006年第1期7-9,共3页
Chinese Journal of Bone and Joint Injury
关键词
股骨干骨折
带锁髓内针
旋转与成角畸形
预防
Femoral shaft
Intramedullary locking nail
Rotation and angulation
Prevention
