电磁导航交锁髓内钉远端锁钉技术治疗股骨干骨折的初步应用  

ELECTROMAGNETIC NAVIGATION INTERLOCKING INTRAMEDULLARY NAIL TECHNOLOGY FOR TREATMENT OF FEMORAL SHAFT FRACTURES

作　　者：左康康 覃巍[2] 郭青[3] 帕拉提.阿巴拜克力 乔培柳 沈明荃 银乐乐 潘奇林[1] 徐小雄[1] 

机构地区：[1]新疆医科大学第一附属医院骨科,乌鲁木齐830000 [2]襄阳市中心医院骨科 [3]襄阳市中心医院教学办

出　　处：《中国修复重建外科杂志》2014年第10期1204-1207,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨电磁导航交锁髓内钉远端锁钉技术治疗股骨干骨折的早期临床效果。方法 2012年7月-2013年10月,收治53例股骨干骨折。其中男40例,女13例;年龄16-52岁,平均38.3岁。致伤原因：交通事故伤28例,高处坠落伤11例,摔伤7例,挤压伤4例,其他伤3例。开放骨折3例,均为GustiloⅠ度损伤;闭合骨折50例。骨折位于股骨上段17例,中段29例,下段7例。骨折按Winquist分型：Ⅰ型7例,Ⅱ型8例,Ⅲ型22例,Ⅳ型16例;按AO分型：32-A型18例,32-B型28例,32-C型7例。受伤至手术时间3-11 d,平均5d。均采用电磁导航下远端交锁髓内钉植入治疗。结果 53例交锁髓内钉的远端锁钉均在电磁导航下完成,远端锁钉一次成功率达100%;锁钉时间5.0-9.5min,平均7.0 min。术后患者切口均Ⅰ期愈合,无皮肤坏死、感染、窦道形成等术后早期并发症发生。53例均获随访,随访时间5-12个月,平均9个月。1例出现臀部疼痛、臀中肌肌力减弱,取出髓内钉后症状消失。随访期间无断钉、退钉、感染、再骨折、外展肌无力、异位骨化等并发症发生。骨折均获临床愈合,愈合时间8-22周,平均14.5周。术后8个月随访49例患者,Lys holm评分获优44例,良4例,可1例,优良率98%。结论电磁导航系统定位精度高、锁钉时间短、无辐射、安全可靠,应用该系统行远端交锁髓内钉植入可取得较好的早期临床效果。Objective To explore the value of electromagnetic navigation interlocking intramedullary nail in the treatment of femoral shaft fracture. Methods Between July 2012 and October 2013, 53 cases of femoral shaft fracture were treated. There were 40 males and 13 females, aged 16-52 years（mean, 38.3 years）. The causes of injury were traffic accident in 28 cases, falling from height in 11 cases, falling in 7 cases, crush injury in 4 cases, and other in 3 cases. Of 53 cases, there were 3 cases of open fracture（Gustilo I degree） and 50 cases of closed fracture. Fracture was located in the proximal femur in 17 cases, middle femur in 29 cases, and distal femur in 7 cases. According to Winquist classii cation, 7 cases were rated as type I, 8 cases as type II, 22 cases as type III, and 16 cases as type IV; according to AO classii cation, 18 cases were rated as type 32-A, 28 cases as type 32-B, and 7 cases as type 32-C. The time from injury to operation was 3-11 days（mean, 5 days）. Distal interlocking intramedullary nail was implanted using electromagnetic navigation. Results The distal locking nail operation with interlocking intramedullary nail was successfully completed under electromagnetic navigation; the one-time success rate of distal locking nail operation reached 100%; and the locking nail time was 5.0-9.5 minutes（mean, 7.0 minutes）. Healing of incision by first intention was obtained after operation, and no complication of skin necrosis, infection, and sinus tract occurred. Fifty-three cases were all followed up 5-12 months（mean, 9 months）. One case had hip pain and weaken middle gluteal muscle strength, and the symptoms disappeared after removing the nail. During the follow-up period, no broken nails, nail exit, infection, or re-fracture occurred. All fractures achieved clinical healing, and the healing time was 8-22 weeks（mean, 14.5 weeks）. In 49 patients followed up 8 months, the Lysholm score was excellent in 44 cases, good in 4 cases, and acceptable in 1 case, with an excellent and good r

关 键 词：电磁导航系统 交锁髓内钉 远端锁钉 股骨干骨折 

分 类 号：R687.3[医药卫生—骨科学]