股骨重建髓内针治疗股骨干骨折合并同侧髋部骨折36例

目的评价股骨重建髓内针治疗股骨干骨折合并同侧髋部骨折的临床疗效，并指出手术操作中应注意的问题。方法选取股骨干骨折合并同侧髋部骨折36例(包括股骨颈骨折27例，转子间骨折9例)，均用股骨重建髓内针（reconstructionnail）治疗。结果所有病例随访6～36个月，平均20个月。全部股骨干骨折均在术后6个月内获得愈合，股骨颈骨折除1例发生迟延愈合外，其余均在3个月内愈合。1例近端锁钉折断。无髓内针和远端锁钉断裂。未发生感染和栓塞等并发症。结论股骨重建髓内针治疗股骨干骨折合并同侧髋部骨折是一种比较理想的内固定方法，可同时对两个部位的骨折进行固定，并且可采取不切开骨折端的闭合方式植入，手术切口小、时间短、固定效果可靠，减少了手术中出血和对骨折端血运的破坏，有利于骨折的愈合。

Reconstruction nail for ipsilateral femoral shaft and hip fractures

Objective To evaluate the effect of the reconstruction nail for ipsilateral hips and femoral shaft fracture and problems in the operative techniques. Methods This study reviewed 36 patients with ipsilateral hips and femoral shaft fracture treated at Beijing Jishuitan Hospital from March 1997 to September 1999 (27 femoral neck fractures and 9 intertrochanteric fractures). All the patients were treated with reconstruction nail. Results The mean follow up time was 20 months, the mean operation time was 2 h and the mean blood loss was 300 ml. Femoral shaft fracture union was within 6 months, femoral neck fracture union was within 3 months except one case. Proximal locking screw was broken in 1 patient; no infection or embolism syndrome occurred. Conclusions Reconstruction nail for ipsilateral fractures of the femoral shaft and hip is a good method, and it can stable both femoral shaft and hip fractures concurrently and does not disturb blood supply of fracture site.