股骨重建型髓内钉联合环扎钢丝治疗股骨转子下骨折  

Reconstruction of femoral intramedullary nail plus wire cerclage in treatment of femoral subtrochanteric fracture

作　　者：侯玉波[1] 王志辉[1] 田雳 马宝银 卢晓光[1] 李巍然[1] 张立明[1] 李小伟[1] 

机构地区：[1]玉田县医院骨一科,河北玉田064100

出　　处：《临床骨科杂志》2014年第2期170-172,共3页Journal of Clinical Orthopaedics

摘　　要：目的：探讨股骨重建型髓内钉联合环扎钢丝治疗股骨转子下骨折的方法和疗效。方法应用股骨重建型髓内钉结合钢丝导引钳微创置入环扎钢丝治疗31例股骨转子下骨折患者。结果31例均获得随访，时间6～24个月。骨折均愈合，愈合时间15～22周。无感染、断钉、退钉、骨不连、肢体短缩或内翻畸形发生。参照Charnley髋关节功能评分标准评定：优19例，良9例，中3例，优良率90.3％。结论股骨重建型髓内钉结合环扎钢丝能较好地解决股骨转子下骨折高应力集中问题，能尽量恢复股骨皮质的连续性，从而减少了髓内钉的负担，避免内固定物的松动或断裂的发生，是治疗股骨转子下骨折较理想的内固定物组合。Objective To investigate the method and curative effect of cerclage wire with reconstruction intramedul- lary nail in the treatment of subtrochanteric femur. Methods Femoral reconstruction intramedullary nail combined with steel wire guided by minimally invasive implantation were used in 31 cases of subtrochanteric fracture. Results 31 patients were followed up for 6 ~ 24 months, all fractures got healing and the healing time was from 15 to 22 weeks, there was no infection, nail breaking, screw withdrawal, nonunion, limb shortening and varus deformity. Ac- cording to the Charnley hip function score evaluation, the results were excellent in 19 cases, good in 9, fair in 3, and the excellent and good rate was 90.3%. Conclusions Reconstruction of femoral intramedullary nailing combined with cerclage wires can better solve the subtrochanteric fracture of high stress concentration problems, which restore the continuity of the femoral cortex, reduce the intramedullary nail burden, and avoid loosening and breakage of inter- nal fixation. This is the ideal fixation combined treatment of subtrochanteric fractures.

关 键 词：髓内钉 环扎钢丝 骨折固定术 髓内 股骨转子下骨折 

分 类 号：R683.42[医药卫生—骨科学] R687.32[医药卫生—外科学]