重建钉治疗股骨干合并同侧股骨颈骨折  

Reconstruction intramedullary nailing for treatment of ispsilateral femoral neck and shaft fractures

作　　者：王浩[1] 李连华[1] 刘智[1] 张建政[1] 郭永智[1] 

机构地区：[1]北京军区总医院骨科,北京100700

出　　处：《中国骨伤》2015年第9期808-810,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的 ：评价重建钉治疗同侧股骨干合并股骨颈骨折的临床疗效及手术方法。方法 ：自2007年1月至2013年1月共采用股骨重建钉固定手术治疗同侧股骨干合并股骨颈骨折患者13例,其中男11例,女2例;年龄25~53岁,平均38.9岁。其中股骨颈骨折依据骨折部位分为基底型10例,经颈型3例;依据Garden分型：Ⅱ型10例,Ⅲ型2例,Ⅳ型1例。股骨干骨折依据Winquist分型：Ⅰ型5例,Ⅱ型4例,Ⅲ型3例,Ⅳ型1例,骨折部位均为股骨干中上3/4。记录患者并发症及术后患肢功能恢复情况。结果 ：11例患者得到随访,随访时间12~36个月,平均23.45个月。受伤至手术时间平均5.9 d。1例患者出现股骨颈骨折畸形愈合,2例患者出现股骨干骨折不愈合,无感染、股骨头坏死及股骨干畸形愈合患者。依据Friedman-Wyman疗效评价标准,优良8例,一般2例,差1例。结论：股骨重建钉是股骨干合并同侧股骨颈骨折治疗中的一种良好内固定方式,具有创伤小、并发症少等优势。ABSTRCAT Objective：To evaluate the curative effect and surigical skills of reconstruetion intramedullary nailing in the treatment of ipsilateral femoral neck and shaft fractures. Methods：From January 2007 to January 2013,13 patients with ipsilateral femoral neck and shaft fractures were treated by reconstruction intramedullary nailing including 11 males and 2 females with an average age of 38.9 yeas old ranging from 25 to 53 years old. For femoral neck fractures,10 cases were basilar neck fracture,3 were transcervical fractures and according to Garden classification,10 were type Ⅱ,2 were type Ⅲ and 1 was typeⅣ. For feormal shaft fracture,5 were type Ⅰ,4 were type Ⅱ,3 were type Ⅲ and 1 was type Ⅳ according to Winquist classification. The location of all 13 feormal shaft fractures were all in the uper 3 / 4 of the feormal shaft. Complications and postoperative function were recorded and evaluated. Results：Eleven patients were followed up for 23.45 months（12 to 36 months）.Time from injury to operation was 5.9 days in average. Malunion of femoral neck fracture happened in 1 patient,nonunion of femoral shaft fracture happened in 2 patients. NO femoral head osteonecrosis,infection and malunion of femoral shaft fracture happened. According to Friedman-Wyman classification,8 cases get good result,2 get faii and 1 get poor. Conclusion：Reconstruction intramedullary nailing is a good choice for the ipsilateral femoral neck and shaft fractures with the advantages of less soft tissue trauma and complications.

关 键 词：股骨骨折 股骨颈骨折 骨折固定术 内 外科手术 

分 类 号：R683.42[医药卫生—骨科学]