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Søren Erik Larsen Kaspar Saxtrup Nielsen Morten Schultz Larsen Søren Skydt Kristensen 《Journal of orthopaedic science》2000,5(4):328-332
Ninety consecutive femoral shaft fractures in 87 patients treated by reamed Grosse-Kempf intramedullary nailing were reviewed.
The median observation time was 45 months. The functional results were excellent or good in 82% of the fractures, fair in
16%, and poor in 2%. Four non-unions and two superficial infections were observed. Leg shortening of more than 2 cm was recorded
in 2 patients. Rotatory malalignment exceeded more than 15° in 2 patients. We conclude that reamed Grosse-Kempf intramedullary
nailing is an excellent treatment for femoral shaft fractures. Although this study represents the first period during which
we used the nail, the number of complications was acceptable.
Received: July 8, 1999 / Accepted: December 6, 1999 相似文献
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交锁髓内钉治疗股骨干骨折(附45例报告) 总被引:26,自引:4,他引:22
目的: 探讨使用交锁髓内钉治疗股骨干骨折的应用、手术方式选择及疗效。方法: 对使用交锁髓内钉治疗 45例 (48肢) 股骨干骨折的疗效进行回顾性分析。手术采用闭合、小切口或有限切开复位, 用三维瞄准器锁定骨折远、近端。结果: 48例患者平均随访 13. 5个月, 肢体、关节功能恢复优良率 91. 1%(41 /45), 一期骨折愈合率 89. 6% (43 /48 )。平均骨临床愈合时间 6. 8个月。感染率 2. 1% ( 1 /45 )。1例髓内钉断裂。结论: 交锁髓内钉是目前治疗股骨干骨折的首选方法, 术中应常规静力固定, 不剥离或少剥离骨膜, 不强求解剖复位, 尽量闭合复位、有限扩髓。 相似文献
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交锁髓内钉治疗股骨干粉碎性骨折 总被引:16,自引:2,他引:14
目的探讨使用交锁髓内钉治疗股骨干粉碎性骨折的手术方式选择、疗效。方法对1998年1月~2002年10月使用交锁髓内钉治疗67例(76肢)股骨干粉碎性骨折的疗效进行回顾性分析。手术采用闭合、小切口或有限切开复位,用三维瞄准器锁定骨折远近端。结果平均随访14.1个月,肢体、关节功能恢复优良率92.5%(62/67),一期骨折愈合率90.8%(69/76)。平均骨临床愈合时问6.7个月。2例软组织感染,感染率2.6%,2例髓内钉断裂。结论交锁髓内钉治疗股骨干粉碎性骨折应常规静力固定,不剥离或少剥离骨膜.不强求解剖复位,尽量闭合复位、有限扩髓,是目前治疗股骨干粉碎性或多节段骨折的有效方法。 相似文献
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带锁髓内钉内固定治疗股骨干骨折 总被引:10,自引:2,他引:8
目的 :报告带锁髓内钉内固定治疗股骨干骨折的治疗效果及临床应用体会。方法 :本组 43例 ,平均年龄 35岁 ,均为闭合骨折 ,其中Hansen Winquist分型I型 2例 ,II型 4例 ,Ⅲ型 1 9例 ,Ⅳ型 1 8例。应用带锁髓内钉动力型固定 6例 ,静力型固定 37例。结果 :43例中 41例获得随访 ,随访 6~ 2 4个月 ,平均 1 1个月 ,骨折全部愈合 ,下肢功能及关节活动均正常。结论 :本方法治疗股骨干骨折稳定可靠 ,临床效果满意 ,并发症少。 相似文献
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Fifty femur fractures were treated with the Brooker-Wills intramedullary locking nail. The indications included subtrochanteric, subisthmal, segmental or comminuted acute fractures or nonunions, and intramedullary shortening procedures. Eighteen technical problems in 13 (26%) patients were encountered during insertion of the nail. The incidence of technical problems was high early in the series and in procedures done with the patient in the supine position. Adverse clinical results from technical errors occurred in two patients. Most technical errors seem avoidable with careful technique. The mean healing time was only 12.1 weeks and there were four nonunions (8%). One patient had a 10 degrees malunion, four patients had 1-2 cm of shortening, and there were two late device fractures. No patients had rotational malalignment or deep infections. The results and complication rate are comparable to those reported for other interlocking systems. The Brooker-Wills nail is useful for treatment of complex femur fractures and has been effective in preventing malrotation, angulation, and excessive shortening. 相似文献
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Treatment of ipsilateral hip and femoral shaft fractures with reconstructive intramedullary interlocking nail 总被引:9,自引:0,他引:9
Objective: To evaluate the results of reconstructive intramedullary interlocking nail in the treatment of ipsllateral hip and femoral shaft fractures. Methods: From August 1997 to November 2001, 13 patients were treated with the reconstructive intramedullary interlocking nail. Nine patients were associated with ipsllateral femoral neck fractures, three with ipsilateral intertrochanteric fractures, and one with subtrochanteric fracture. Results: The follow-up time was from 6 to 38 months with an average of 14 months. All the femoral shaft and hip fractures healed up well. There was no nonunion of the femoral neck, and only one varns malunion. No patient had avascular necrosis of the femoral head. The average healing time for femoral neck fracture was 4.6 months and for shaft fracture 5.8 months. The joint movement and other functions were fairly resumed. Conclusions: The reconstructive intramedullary interlocking nail, with less trauma, refiable fixation, and high rate of fracture healing, is an ideal method of choice in the treatment of ipsilateral hip and femoral shaft fractures. 相似文献
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Tsourvakas S Alexandropoulos C Papachristos I Tsakoumis G Ameridis N 《Musculoskeletal surgery》2011,95(3):193-198
Antegrade interlocked humeral nailing for stabilization of humeral fractures was introduced many years ago, and studies on
this method in the orthopedic literature have shown mixed results. The purpose of this investigation was to document the clinical
outcome and complications associated with the use of an antegrade intramedullary nail (T2, Stryker) for the humeral fractures.
Between 2005 and 2008, 52 fractures of the humeral shaft were treated operatively with this intramedullary nail in our department.
Eight patients were polytraumatized, and four patients had an open fracture. The mean age of patients was 51.7 years. Forty-eight
patients had an adequate duration of clinical follow-up (a mean of 18 months) for analysis. Complications were recorded, and
the time to union was measured. Shoulder and elbow functions were assessed using the Constant Score and the Morrey Score,
respectively. Forty-six fractures healed, with a mean time to clinical union of 10.3 weeks. Two patients developed pseudarthroses.
There were four adverse events: two proximal screws backed out, one superficial infection at the insertion point, and one
fracture at the distal end of the nail. Ninety-one percentage of patients had an excellent or good shoulder function. Five
further operations were necessary: two for treatment of pseudarthroses, two for removal the backed out proximal screws, and
one wound debridement for superficial infection. Antegrade humeral nailing is a valid therapeutic option for stabilization
of humeral shaft fractures. By strictly adhering to the operation technique, the number and the severity of complications
can be reduced. When good fracture alignment and stability are obtained, uneventful bone healing with good functional results
is the rule. 相似文献
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股骨干顺行髓内钉固定后同侧股骨颈骨折的治疗 总被引:1,自引:1,他引:0
目的:探讨股骨干骨折行顺行髓内钉固定后发现同侧股骨颈骨折的治疗方法。方法:回顾性分析2000年1月至2010年1月股骨干骨折行顺行髓内钉固定后术中或术后发现同侧股骨颈骨折的患者12例,全部以2枚螺钉分别自髓内钉前后方固定股骨颈骨折,定期随访,评估骨折愈合及功能恢复情况。结果:术后随访10—36个月,平均16.5个月。股骨颈骨折平均愈合时间3.6个月,股骨干骨折平均愈合时间5.4个月,无股骨头坏死发生。按Harris评分标准髋关节功能:优7例,良3例,可2例。结论:股骨干骨折顺行髓内钉固定后发现同侧股骨颈骨折,以2枚螺钉分别自髓内钉前后方固定股骨颈骨折方法可行,固定可靠,手术创伤小,骨折愈合率高。 相似文献
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OBJECTIVE: To discuss the experience treating fresh femoral shaft fractures with un-reamed intramedullary nail. METHODS: 203 cases of fresh femoral shaft fractures who had been treated with un-reamed intramedullary nail from November. 1995 to January. 1999 were analyzed retrospectively. 18 cases were open, classified as Gustilo I, and. 185 cases were closed. Traction table and image intensifier were used during operation. Closed reduction, un-reamed and free hand distal locking technique were used. Active movements of nearby joints were encouraged and partial weight bearing of 10 - 15 kg were allowed right after operation. RESULTS: All 203 cases of fresh femoral shaft fractures got bone union within 4 - 6 months. No case of delayed union and infection happened. 1 distal locking screw was broken. All patients gained normal extremity functions. CONCLUSION: Un-reamed intramedullary nailing of fresh femoral shaft fracture has less damage to the local soft tissue and blood supply. It has a relative stable fracture fixation, and less interruption to the healing procedure. It is one of the best methods for treating femoral fracture. 相似文献
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带锁髓内钉治疗股骨干骨折合并股骨颈及转子间骨折或转子下粉碎骨折 总被引:22,自引:0,他引:22
目的应用带锁髓内钉治疗股骨干骨折合并同侧股骨颈骨折及转子间骨折或转子下粉碎骨折。方法在1996年7月~1998年11月收治的16例复杂股骨骨折中,股骨干骨折合并同侧股骨颈骨折3例,合并转手间骨折4例,转子下粉碎骨折9例。其中10例应用国产加长型Gamma钉,6例使用Russell-Taylor股骨重建钉固定。结果所有病例随访6~22个月,平均11个月。除1例股骨干骨折合并同侧股骨颈骨折患者术后7个月出现股骨头坏死外,其余15例骨折均愈合,平均愈合时间5.5个月,患肢关节功能优良。经此方法治疗后可早期活动关节及功能锻炼、手术创伤小、切口小、固定可靠、骨折愈合率高。结论 对股骨干骨折合并同侧股骨颈骨折及转手间骨折或转子下粉碎骨折的治疗,带锁髓内钉具有明显优势。 相似文献
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非扩髓凹槽交锁髓内钉治疗开放性胫骨骨折 总被引:1,自引:0,他引:1
目的 介绍凹槽交锁髓内钉治疗胫骨开放性骨折的手术方法、特点及其适应证。方法 胫骨开放性骨折28例,按Gustilo分型:Ⅰ型18例,Ⅱ型8例,Ⅲa型2例,采用凹槽髓内钉直径8mm26例,直径7mm2例。结果 所有患不需X线透视均精确锁定,骨折复位良好,固定牢固,经平均5.6个月随访,伤口无感染,骨折均骨性愈合,无针、钉断裂发生。结论 凹槽交锁髓内钉具有操作简单,创伤小,适应证范围广,固定牢固以及不扩髓等优点。 相似文献