摘要
目的探讨逆行髓内钉加空心钉内固定治疗股骨干合并同侧股骨颈骨折的适应证。方法回顾分析北京军区总医院2001年1月—2011年1月采用逆行髓内钉加空心钉治疗的股骨干合并同侧股骨颈骨折11例的病例资料,并评估疗效。结果全部病例手术顺利,术后均获随访,随访时间12～36个月,平均26.4个月。10例股骨干骨折一期获得骨性愈合,愈合时间为(6.0±5.4)个月;股骨颈骨折全部获得骨性愈合,愈合时间为(5.6±3.7)个月。1例股骨干狭部骨折延迟愈合,3例股骨颈骨折发生肢体短缩,平均短缩1.8 cm,2例并发膝关节痛,1例伸膝装置粘连。Friedman-Wyman评定:优8例,良2例,差1例。结论逆行髓内钉加空心钉内固定治疗股骨干合并同侧股骨颈骨折的最佳适应证为股骨干远端骨折合并头下型骨折或骨质疏松性股骨颈骨折,以及需要同时处理膝关节内损伤、关节周围骨折者。
Objective To explore the indication of retrograde nailing with hollow screw internal fixation in treat- ment of ipsilateral femoral shaft and neck fractures. Methods Clinical data of 11 patients with ipsilateral femoral shaft and neck fractures during January 2001 and January 2011 in our hospital, who were treated with retrograde nailing with hollow screw internal fixation, was retrospectively analyzed, and curative effect was also evaluated. Results All patients were operated successfully, and were followed up for 12-36 months. The average follow-up time was 26.4 months. Ten patients with fractures of shaft of femur had synostosis within stage I , and the healing time was （6.0 ± 5.4） months ; pa- tients with femoral neck fractures all had synostosis, and the average healing time was （5.6 ± 3.7） months. There was 1 patient with delayed union of shaft fracture, 3 patients with limb shortening of femoral neck fractures （ average shortening was 1.8 cm） , 2 patients with combination of knee-joint pain, and 1 patient with straight knee joint adhesion devices. Friedman-Wyman evaluation showed good in 8 patients, ordinary in 2 and bad in 1 patient. Conclusion The best surgi- cal indications of retrograde nailing with hollow screw internal fixation in treatment of ipsilateral femoral shaft and neck fractures are for patients with distal femoral shaft fractures, femoral neck fractures with osteoporosis, and combination of genual intraarticular damage and acroteric joint fractures.
出处
《解放军医药杂志》
CAS
2013年第5期33-36,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
全军临床高新技术资助项目(2010JXJS007)
关键词
股骨干骨折
股骨颈骨折
骨折固定术
内
骨钉
Femoral shaft fracture
Femoral neck fracture
Fracture fixation, internal
Bone nail
