非扩髓交锁髓内钉治疗股骨干骨折临床疗效观察

目的:探讨非扩髓交锁髓内钉治疗股骨干骨折的临床疗效.方法:2006～2008年,我们对36例(38肢)股骨干骨折患者采用非扩髓交锁髓内钉治疗,其中男24例(25肢),女12例(13肢),平均年龄49岁.术前和术后均行X线片检查,术后通过临床和放射学随访,平均24个月,观察骨折愈合情况.结果:36例(38肢)患者骨折均愈合,闭合性骨折愈合时间10～16周,平均13周,开放性骨折愈合时间14～28周,平均21周.有3例患者股骨远端交锁钉发生断裂,2例患者轻度外翻成角畸形.所有患肢术后功能良好,二次手术取出髓内钉后无再次骨折发生.结论:非扩髓交锁髓内钉治疗股骨干骨折有手术创伤小,手术时间短,对骨内膜血运破坏少,骨折愈合不利影响小等优点.但易发生断钉,在使用非扩髓交锁髓内钉时,需综合考虑多方面因素,扬长避短.

Clinical effective obfservation of femoral shaft fractures treated with non-reamed interlocking intramedullary nailing

Objective：To investigate the efficacy of femoral shaft facture treated with non-reamed interlocking intramedullary nailing.Methods：From 2006 to 2008,36 patients（38 limbs）with femoral shaft fracture were treated with non-reamed interlocking intramedullary nailing in our hospita1.There were 24 men（25 limbs）and 12 women（13 limbs）with an average age of 49 years old,Radiographs were done preoperatively and postoperatively.Fractures healing was reviewed by clinical and radiographic follow-ups（averaging 2 years）postoperatively.Results：36 patients（38 limbs）with fracture were recovered.The recovery times of closed fractures were 10-16 weeks,and open fractures were 14-28 weeks.There were 3 patients with distal femoral interlocking nail fracture,2 patients with mild valgus deformity.All patients recovered and had good function after surgery.Conclusion：Non-reamed interlocking intramedullary nailing of femoral shaft fracture has several advantages including less surgical trauma,shorter operation time and less damage to the blood supply in the fracture.However,because of the smaller size of the selected intramedullary nail,it is prone to be easily broken.Therefore,the clinical use of non-reamed interlocking intramedullary nailing should be subjected to the consideration of the above multiple factors,avoid weakness.