髓腔延长顺行交锁髓内钉治疗股骨远端骨折基础与应用研究

目的探讨髓腔延长顺行交锁髓内钉治疗股骨远端骨折的临床疗效。方法：(1)107例成人股骨X线正、侧位片观测髓腔形态结构特点；(2)在X线片上测量估算髓内钉可达到股骨远端的最远距离，复位骨折，术中X线临测扩髓延长股骨远端髓腔至关节面上10～15mm，采用髓腔延长顺行交锁髓内钉治疗股骨远端骨折12例，2例不稳定骨折髓内钉同定后均加用小钢板单侧骨皮质螺钉同定。结果：12例骨折均达解剖复位或接近解剖复位，全部愈合。结论：髓腔延长顺行交锁髓内钉治疗股骨远端骨折具有创伤小，基本不损伤膝关节，术中出血少，稳定性好，膝关节功能恢复良好，骨折愈合率高等优点，值得临床推广和应用。

The study on medullary cavity extension and anterograde interlocking intramedullary nail in treatment of the distal femoral fracture

s]Objective: To explore the therapeutic effects of medullary cavity extension and anterograde interlocking intramedullary nail in treatment the distal femoral fracture. Methods: The morphologic characteristics of the medullary cavity of the femur were measured by X-ray on 107 cases of adult femur specimens. The farthest distance of the nail tip to the distal femur was estimated. 12 cases of distal femoral fracture were treated with internal fixation by medullary cavity extension and anterograde interlocking intramedullary nail. Results: The mean height of the femoral intercondylar fossa was about 6~9mm. 1.5cm of the nail tip above the distal femoral transverse plane was the safe distance. All cases of fracture attained the anatomic replacement and excellent healing. Conclusions: The therapeutic application of medullary cavity extension and anterograde interlocking intramedullary nail in treatment of the distal femoral fracture have some advantages, including tiny trauma and blooding, without injury for knee joint, strong fixation effects, good functional recovery of knee joint and well healing rate. It was valuable to spread and applicate in clinical practice.