股骨重建钉治疗股骨粗隆下骨折的应用

目的探讨股骨重建钉治疗股骨转子下骨折的手术方法及临床疗效。方法 2007年6月至2010年3月,采用股骨重建钉对24例股骨粗隆下骨折患者进行固定,其中男19例,女5例;年龄26～55岁,平均42.9岁。依据Seinsheimer分类,Ⅱ型5例,Ⅲ型8例,Ⅳ型6例,Ⅴ型5例。高能量损伤17例,低能量损伤7例,开放骨折2例。结果 24例随访12个月～2年3个月,平均术后平均随访16个月,X线观察骨折愈合时间4.3个月(3.6～6.2个月),按韩一生评分标准,优18例,良4例,可2例,优良率92%。无感染、内固定失效、畸形愈合及股骨头缺血性坏死等并发症。结论股骨重建钉治疗股骨粗隆下骨折是一种有效方法 ,具有固定可靠、并发症少、骨折愈合率高等优点。精细的手术操作是手术成功的关键。

Application of reconstruction interlocking nail for treatment subtrochanteric femoral fracture

Objective To investigate the surgical techniques and clinical results of the treatment of subtrochanteric femoral fracture with the reconstruction interlocking nail.Methods A total of 24 cases（19 males and 5 females,at age ranged from 26 years to 55 years,mean 42.9 years）with subtrochanteric femoral fracture were fixed with reconstruction interlocking nail in our hospital from June 2007 to March 2010.The fractues were classified according to Seinsheimer,the type Ⅱ 5 cases,type Ⅲ8,type Ⅳ 6 and type Ⅴ 5,17 patients sustained high-energy injury,and 7 low-energy.2 cases were open fractrues.Results The followed-up period ranged from 12 months to 2 years and 3 months with an average of 16 months.The average time for bony union on X-ray was 4.3 months（from 3.6 to 6.2 months）.According to HAN＇s scoring system there were 18 excellent cases,4 good cases and 2 fair cases.The excellent and good rate was 92%.There was no severe complications,such as incision infection,fixation failure,deformity or ischemic necrosis of femoral head.Conclusion Reconstruction interlocking nail is an effective operation for treatment of subtrochanteric femoral fracture.This method has obvious advantages of reliable fixation,few complication and high bone union rate.Meticulous surgical techniques is the key of success for the operation.