Russell-Taylor重建钉内固定治疗股骨干多节段骨折并同侧股骨颈骨折

目的 探讨使用Russell-Taylor股骨重建钉内固定治疗股骨干多节段骨折并同侧股骨颈骨折的临床疗效、手术要点和围手术期注意事项。方法 对1998年6月～2002年10月使用股骨重建钉静力固定治疗7例的疗效进行回顾性分析。手术采用闭合穿钉、小切口切开复位。结果 平均股骨颈骨折临床愈合时间5.2个月、股骨干骨折7.3个月,一期骨折愈合率达到71.4％(5/7),其中2例术后12、15个月远端骨折段骨延迟愈合改为动力固定,4～6个月后骨折愈合。无股骨头坏死征象。1例浅表感染。结论 股骨颈骨折强调不切开复位,并争取解剖复位;股骨干骨折则常规闭合穿钉、小切口复位、有限扩髓、静力固定。认为股骨重建钉是目前治疗股骨干多节段骨折并同侧股骨颈骨折的最佳方法。

Treatment of Shaft Comminuted Segment Fractures with Ipsilateral Femoral Neck Fractures by Russell-Taylor Recontruction Interlocking Nail

Objective To explore the clinical application and the optimal manners of interlocking nail with recontruction interlocking nail in treating shaft comminuted segment fractures with ipsilateral femoral neck fractures. Methods Seven cases were reviewed. The di-aplasis of the fracture was opened with only a little incision, and the two sides of the fracture were locked with nails by an aim implement. Two lag screws were inserted into the femoral neck with 15 degree dip angel. Results Averaged period of femoral neck fractures healing was 5. 2 months and shaft fractures 7.3 months. Seventy one and point four percent. (5/7) showed concrescence of fracture. Infections were found in 1 cases. There were no necrosis of femoral head and no femoral neck nonunion or malunion and no nails rupture. Conclusion Recontruction interlocking nail is a principal way in treating ipsilateral fractures of femoral neck and shaft because of its effective fixation and excellent clinical effect. Anatomy reduction of femoral neck and not open reduction are emphasized. Closed nail insertion of femoral shaft fractures, limited enlarging marrows and static locking should be a routine way in the operation.