重建型交锁髓内钉与动力髋螺钉治疗股骨复杂性骨折的随访比较

背景：骨折后植入物内固定主要有髓内钉和钢板两种，如何合理选择适宜的内固定器械，对临床疗效及并发症等问题至关重要。 目的：重建型交锁髓内钉和动力髋螺钉钢板治疗股骨复杂性骨折的随访疗效比较。 方法：回顾性分析70例股骨干骨折合并同侧股骨颈骨折、转子间骨折、转子下骨折，股骨干多段骨折患者的临床资料，内固定植入物有重建型交锁髓内钉和动力髋螺钉钢板两种。 结果与结论：全部患者随访3个月以上。重建型交锁髓内钉组的早期功能恢复、骨折愈合时间相对优于动力髋螺钉组。在并发症方面动力髋螺钉易出现髋内翻和内固定失败，重建型交锁髓内钉易出现锁钉松动。在切口感染和脂肪栓塞综合征发生率方面，两者差异无显著性意义。故可认为重建型交锁髓内钉具有同时静力加动力固定两处骨折的功能，符合生物力学重建原则和骨折愈合快等优点，是一种优于动力髋螺钉的有效内固定器械。

Follow-up comparison of the double neck and shaft fracture nail and dynamic hip screw in the treatment of femoral complexity fractures

BACKGROUND: Fracture fixations are divided into an intramedullary nail fixed and steel plate fixed two methods, how to choose a fixation devices for clinical curative effect and postoperative complications is crucial. OBJECTIVE: To make a clinical curative effect comparison using reconstruction interlocking intramedullary nail (double neck and shaft fracture nail, DNS) and dynamic hip screw (DHS) steel in treating the femoral complexity fractures . METHODS: Totally 70 cases of femoral fractures merger with side femoral neck fracture, between rotor fracture, subtrochanteric fractures, femoral fractures were analyzed retrospectively. Internal fixation implant was used DNS and DHS. RESULTS AND CONCLUSION: All cases were followed-up 3 months, early functional recovery and fracture healing time in the DNS group were better than that of the DHS group. Relative complications in the DHS group were easily found hip equinovarus and fixation failure, and in the DNS group were easily found screw loosening. There was no significant difference of incision infection and fat embolism syndrome in the two groups. DNS has static and dynamic fixed function of two fractures. It is accord with biomechanics reconstruction principles and fracture healing fast. DNS is a better and effective internal fixation device as compared with DHS.