股骨重建髓内钉治疗复杂股骨骨折的评价

目的：评价股骨重建髓内钉治疗股骨干骨折合并同侧股骨颈、转子间骨折或转子下粉碎性骨折的临床疗效。方法：对2000年10月至2004年6月采用股骨重建髓内钉治疗的15例股骨干合并同侧股骨颈、转子间骨折或转子下骨折的病例进行回顾性分析。结果：所有病例随访7～28个月，平均15．4个月，骨折平均愈合时间7．2个月。无术后感染、股骨头缺血坏死及内固定材料断裂等并发症发生，远期疗效按马元璋评定标准优良率达85．7％。结论：股骨重建髓内钉固定复杂股骨骨折，使股骨头、颈、干重新成为一个相对牢固的整体，有利于患肢早期功能锻炼、早期负重，促进了骨折的愈合。

Evaluation of femoral reconstruction intramedullary nail fixation for complex femoral fracture

Objective: To evaluate the efficacy of femoral reconstruction intramedullary nail fixation for treating with femoral fracture combining with ipsilateral femoral neck fracture, intertrochanteric fracture or subtrochanteric fracture. Methods: Retrospective analysis was performed for 15 patients suffering from femoral fracture accompanying ipsilateral femoral neck fracture, intertrochanteric fracture or subtrochanteric fractureand and treating with femoral reconstruction intramedullary nail fixation from October, 2000 to June, 2004. Results: All cases were followed up, ranging from 7 to 28 months, averagely about 15.4 months and the average time for union of fracture was about 7.2 months. No postoperative infection, avascular necrosis of femoral head and failure of internal fixation occurred. According to Ma Yuanzhang criterion system, the percentage of excellent clinical result was 85.7%. Conclusions: Femoral reconstruction intramedullary nail fixation is an ideal surgical treatment for complex femoral fracture. By this process, femoral head, neck and shaft become an intact bony structure again, which is benefit for weight-bearing and exercise more early.