撬拨辅助钉道控制在闭合治疗股骨转子下骨折中的意义

目的 评估术中使用斯氏针撬拨辅助钉道控制闭合复位的效果. 方法 23例股骨转子下骨折,术中用斯氏针置入股骨大转子后部协助复位,闭合复位后股骨近端髓内钉(PFN)或抗旋股骨近端髓内钉(PFNa)固定. 结果 23例患者手术时间30～55 min,平均39 min,出血量50～120 ml,平均76 ml.术中透视、术后X线复查骨折对位对线优良,骨折全部获得愈合,无严重并发症. 结论在髓内钉治疗股骨转子下骨折时,股骨近侧置入斯氏针撬拨辅助钉道控制能较好纠正和控制股骨转子下骨折近端骨折块的移位,手术时间短,创伤小,固定可靠.

Role of joystick-assisted nail insertion in close reduction and internal fixation of subtrochanteric fractures

Objective To evaluate the effect of joystick-assisted natl insertion in close reduction and internal fixation of subtrochanteric fractures. Methods The study involved 23 patients with subtruchanteric fractures treated in our hospital. Schanz pins were placed into the posterior part of the femoral trochanter to assist the reduction of the displaced fragment before fixation with proximal femoral natl (PFN) and proximal femoral natl anti-rotation (PFNa). Results The operation lasted for mean 39 minutes (30-55 minutes), with mean blood loss of 78 ml (50-120 ml). Roentgenography showed good alignment on follow-up and fracture healing, with no serious complication observed. Conclusions Schanz pin inserted in femoral trechanter can help reduce the displaced proximal fragment in patients with subtrochanteric fractures, with advantages of short operation time, minor trauma and stable fixation.