青少年型带锁髓内钉治疗股骨干骨折对股骨近端的影响  

Effect of adolescent interlocking intramedullary nail on the proximal femur in the treatment of femoral shaft fractures

作　　者：卢育南 汪文涛 潘源城 陈顺有 Lu Yu-nan;Wang Wen-tao;Pan Yuan-cheng;Chen Shun-you(Department of Orthopedics,Fuzhou Second Hospital,Xiamen University,Fuzhou 350007,Fujian Province,Chin)

机构地区：[1]厦门大学附属福州第二医院骨科,福建省福州市350007

出　　处：《中国组织工程研究》2018年第27期4322-4326,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:目前青少年股骨干骨折治疗方式存在争议,国内外对选用青少年型带锁髓内钉治疗股骨干骨折的报道较少。目的:评估青少年型带锁髓内钉治疗股骨干骨折对青少年股骨近端的影响。方法:回顾性分析2014年2月至2016年8月厦门大学附属福州第二医院收治的因股骨干骨折接受青少年型带锁髓内钉治疗共18例患者的临床资料。以健侧为对照,分析末次随访的影像学资料以观察是否出现股骨头坏死、髋外翻畸形、股骨颈狭窄等并发症,应用影像学处理软件测量双侧股骨近端的几何结构参数,并进行健侧及患侧对比。另外,采用非关节炎髋关节功能评分法评估末次随访时患者的髋关节功能。结果与结论:(1)术后所有患者均获得随访,随访时间16-46个月,均达到骨性愈合,且未出现股骨头坏死、髋外翻畸形、股骨颈狭窄等并发症;(2)患侧的股骨近端几何结构参数、髋关节功能评分与健侧的差异均无显著性意义(P均>0.05);(3)结果显示,青少年型带锁髓内钉治疗股骨干骨折短期内对股骨近端不会造成影响,可获得满意疗效。BACKGROUND： The treatment of femoral shaft fractures in adolescents is under discussion. Femoral shaft fracture treated using adolescent interlocking intramedullary nail is seldom reported. OBJECTIVE： To observe the proximal femoral changes in adolescent femoral shaft fractures after treated using adolescent interlocking intramedullary nail.METHODS： Clinical data of 18 patients with femoral shaft fractures undergoing treatment of adolescent interlocking intramedullary nail from February 2014 to August 2016 at Fuzhou Second Hospital, Xiamen University were analyzed retrospectively. The uninjured side was used as control group, and the radiographs at last follow-up were analyzed to assess the incidence of osteonecrosis of the femoral head, valgus deformity of coxa as well as stenosis of femoral neck. The geometric parameters of bilateral proximal femurs were measured by imaging processing software, and then compared between two sides. Additionally, the Nonarthritic Hip Score was used to assess the hip joint function at the last follow-up. RESULTS AND CONCLUSION： （1） All patients were followed up for 16-46 months. All achieved bony union, and none of osteonecrosis of the femoral head, valgus deformity of coxa or stenosis of femoral neck occurred. （2） There were no significant differences in the geometric parameters of proximal femur and the Nonarthritic Hip Score between injured and uninjured sides （all P 〉 0.05）. （3） Our findings indicate that adolescent interlocking intramedullary nail can achieve satisfactory results in the treatment of femoral shaft fractures without complications.

关 键 词：青少年型带锁髓内钉 青少年 股骨干骨折 股骨近端 骨科植入物 股骨近端几何结构参数 髋关节功能 非关节炎髋关节功能评分 临床治疗 

分 类 号：R318[医药卫生—生物医学工程]