股骨粗隆间骨折髓内钉内固定术中旋转畸形分类及其矫正  

Types of rotational deformity and its correction in surgery of femoral intertrochanteric fractures with intramedullary nail

作　　者：徐执扬[1] 吴飞华[1] 吴冯胜[1] 苏新杰[1] 李晗[1] XU Zhi-yang;WU Fei-hua;WU Feng-sheng;SU Xin-jie;LI Han(Department of Orthopaedics, Chuiyangliu Hospital of Beijing, Beijing 100022, China)

机构地区：[1]北京市垂杨柳医院骨科,北京100022

出　　处：《中国骨与关节损伤杂志》2018年第4期343-345,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的介绍股骨粗隆间骨折髓内钉内固定术中旋转畸形分类及其辅助复位方法。方法纳入自2012-01—2016-05采用髓内钉内固定治疗的98例股骨粗隆间骨折。骨折近端的旋转畸形中骨折线远离股骨颈基底时为A类畸形,骨折近端的旋转畸形中骨折线接近股骨颈基底时为B类畸形,骨折远端的旋转畸形为C类畸形。当出现旋转畸形和骨折再移位时,采用辅助复位技术及调整牵引予以矫正。结果 21例(21.4%)术中出现旋转畸形,其中7例为31-A1型骨折,11例为31-A2型骨折,3例为31-A3型骨折。旋转畸形分类:7例31-A1型骨折中A类畸形1例,B类畸形5例,C类畸形1例;11例31-A2型骨折中A类畸形10例,C类畸形1例;3例31-A3型骨折均出现C类畸形。术中出现的旋转畸形采用辅助复位技术矫正及适当牵引调整,17例旋转畸形得到矫正,4例无法矫正。结论股骨粗隆间骨折髓内钉内固定术中应警惕旋转畸形的出现,术者应尽可能矫正旋转畸形以达到骨折解剖复位。Objective To introduce the types of rotational deformity and its correction in surgery of femoral intertrochanteric fractures with intramedullary nail.Methods From January 2012 to May 2016,98 patients with femoral intertrochanteric fractures were treated with intramedullary nail.When fracture line was away from the base of femoral neck,we called it A deformity,fracture line close to the base of femoral neck,B deformity and rotational deformity of distal fragment of intertrochanteric fractures,C deformity.When deformity and redisplacement occurred intraoperatively,we took some measures,such as auxiliary reduction techniques to reestablish the normal relation of fracture fragments as far as possible.Results Rotational deformity occurred in 21 cases intraoperatively（21.4%）.According to the fracture type,it appeared in 31-A1,7 cases（A deformity 1 case,B 5,C 1）,31-A2,11 cases（A deformity 10,C 1）and 31-A3,3 cases（C deformity）,respectively.The auxiliary reduction techniques and appropriate traction were used,17 cases with rotational deformity were corrected intraoperatively,4 cases unsuccessfully.Conclusion In intramedullary nailing surgery of femoral intertrochanteric fracture,a surgeon should be aware of rotational deformity.Once it appears,some methods should be taken to obtain anatomic reduction as far as possible.

关 键 词：股骨粗隆间骨折 髓内钉 内固定 骨折复位 旋转畸形 

分 类 号：R687.3[医药卫生—骨科学]