重建髓内钉治疗股骨干合并同侧转子间骨折的疗效评价

目的评价重建髓内钉治疗股骨干骨折合并同侧股骨转子间骨折的临床疗效。方法对从2002年5月至2007年12月采用股骨重建髓内钉治疗的21例股骨干合并同侧股骨转子间骨折病例进行回顾性分析。结果所有病例随访7～62个月，平均18．7个月，骨折平均愈合时间6．9个月。无术后感染、股骨头缺血坏死及内固定材料断裂等并发症发生，远期疗效按马元璋评定标准优良率达90．0％。结论股骨重建髓内钉颈干交锁，将整个固定系统与股骨头颈干构成一个相对完整牢固的整体，是治疗股骨干骨折合并同侧股骨转子间骨折较理想的方法。

Evaluation of femoral reconstruction intramedullary nail fixation for femoral fracture combining with ipsilateral femoral intertrochanteric fracture

Objective To investigate an effective surgical treatment for complex femoral fracture and evaluate the efficacy of femoral reconstruction intramedullary nail fixation for femoral fracture combining with ipsilateral femoral intertrochanteric fracture.Methods Retrospective analysis was performed for 21 cases suffering from femoral fracture combining with ipsilateral femoral intertrochanteric fracture treated by femoral reconstruction intramedullary nail fixation from May 2000 to December 2004.Results 21 cases were followed up,ranging from 7 to 62 months,average 18.7 months,average time for fracture union was 6.9 months,and no postoperative infection,avascular necrosis of femoral head and failure of internal fixation occurred.According to Ma Yuanzhang criterion system,the percentage of excellent clinical result was 90.0%.Conclusion Femoral reconstruction intramedullary nail fixation is an ideal surgical treatment for femoral fracture combining with ipsilateral femoral intertrochanteric fracture.By this process,femoral head,neck and shaft become an intact body.