髓内钉治疗股骨干骨折合并同侧股骨颈骨折的临床分析

目的：探讨髓内钉在股骨干骨折合并同侧股骨颈骨折的应用方法。方法回顾性分析了2008年1月～2012年6月进行治疗的18例股骨干骨折合并同侧股骨颈骨折的临床资料，18例均采用髓内钉固定，顺行髓内钉固定15例，5例结合空心钉固定，逆行髓内钉结合空心钉固定3例。结果全部病例均获随访，随访时间8～60个月，平均22.4个月。股骨颈骨折术前漏诊率为22.2%。所有股骨干骨折及股骨颈骨折术后均获愈合，未发生内固定物断裂，2例股骨干骨折延迟愈合，分别为18个月和23个月，有2例股骨颈骨折出现股骨头囊性变，但均无临床症状。结论股骨干骨折合并同侧股骨颈骨折漏诊率较高，髓内钉适当结合空心钉治疗股骨干骨折合并同侧股骨颈骨折临床效果可靠。

The Clinical Study in Treatment with Nails of Ipsilateral Femoral Shaft and Neck Fractures

Objective To explore the indication method of nails in treatment of ipsilateral femoral shaft and neck fractures. Method Clinical data of 18 patients with ipsilateral femoral shaft and neck fractures during January 2008 and July 2012 in ours hospital was retrospectively analysis.18 nails were used.Among 15 antegrade nails,there were 6 cases with hollow screw.There were 3 cases with retrograde nails and hollow screw. Results All patients were followed with a mean of 22.4 months （8 to 60 months）.The rate of missed diagnosis was 22.2%.All fractures healed without breakage of implants.2 femoral shaft fractures got delayed fracture healing in 18 months and 23 months.There were 2 cases with cystic change of femoral head without clinical symptoms.Conclusion The rate of missed diagnosis of ipsilateral femoral shaft and neck fractures was high.The clinical effect of ipsilateral femoral shaft and neck fractures was reliable,that we applied nailing combined with hollow nail appropriately.