交锁髓内钉远端锁钉困难的原因及对策  

The Cause and the Treatment of Installation Failure of Inter locking Nail

作　　者：胡钟旭[1] 杜恒胜[1] 刘银军[1] 

机构地区：[1]中山市博爱医院骨科,广东中山528403

出　　处：《实用临床医学（江西）》2005年第7期69-70,73,共3页Practical Clinical Medicine

摘　　要：目的避免交锁髓内钉治疗股骨干骨折时发生的远端锁钉困难。方法总结194例应用交锁髓内钉治疗股骨干骨折的临床资料,分析造成远端锁钉困难的原因及对策。结果本组162例一次锁钉成功,32例出现远端锁钉困难,其中术前适应征选择不当5例;术前准备不够完善3例;支架不配套,安装不细致7例;入针点欠准确2例;骨折复位不理想5例;扩髓不恰当5例;粗心大意安置限位杆5例。结论在安装交锁髓内钉时应按照规范的程序进行手术,操作仔细,避免强外力干扰,可一次锁钉成功。Objective:To analyse why it is difficult to install the dis ta l inter-locking nail in the therapy of fracture of the shaft of the femur and h ow to overcome it.Methods:One hundred and ninety four clinical cases in which in ter-locking nails were used to treat the fracture of the shaft of the femur sin ce 1996 were retrospectively reviewed to analyze the failure reasons.Results:Amo ng 194 cases,162 cases obtained success in the first time and 32 cases did diffi culty to lock the nail's distance end.Of the 32 cases,5 cases were due to an im proper in choosing indication,3 cases due to being not completely prepared befor e the operation,7 cases due to incorrect intruder or careless installation,2 ca ses due to without exact selection of puncturing point, fracture diaplasis was d issatisfaction in 5 cases,enlargement of medallary cavity was improper in 5 case s,5 cases was carelessly installed limit-place-shaft.Conclusion:It should foll ow the criterion,be careful and avoid the strong force disturbance in the operat ion.

关 键 词：交锁髓内钉 股骨干骨折 远端锁钉 

分 类 号：R683.42[医药卫生—骨科学]