自动加压防旋髓内钉的研制及修复股骨中下段骨折的应用  

STUDY AND CLINICAL APPLICATION OF AUTO-COMPRESSIVE AND ANTI-CIRCUMROTATE INTRAMEDULLARY NAIL

作　　者：万黎[1] 徐达传[2] 江振华[1] 樊仕才[1] 张日华[1] 李春华[1] 

机构地区：[1]深圳市沙井人民医院骨科,广东深圳518104 [2]第一军医大学临床解剖研究所

出　　处：《中国修复重建外科杂志》2003年第3期201-204,共4页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：广东省自然科学基金资助项目 (99B0 670 3G)~~

摘　　要：目的　研制一种自动加压防旋髓内钉 ,探讨其生物力学和在修复股骨中下段骨折的应用效果。　方法采用研制的自动加压防旋髓内钉于 1998年 1月～ 2 0 0 1年 6月 ,临床用于修复股骨中下段骨折 2 3例 ,其中横、短斜形骨折 12例 ,粉碎骨折 9例 ,斜形、多段骨折各 1例 ,手术时间为伤后 2小时～ 8天。陈旧性骨折 2例 ,手术时间为伤后 11～ 13个月。在梅花型髓内钉距近远端一定距离的两侧翼开孔 ,置入梅花型弹力环 2～ 4枚以适应股骨髓腔宽大部。手术时间 30～ 75分钟 ,平均 4 3分钟。　结果　在 5 Nm扭矩下 ,自动加压防旋髓内钉的抗旋转作用与交锁钉相近 ;2 3例骨折均愈合 ,其中 2 1例为 6～ 13周 ,平均 9周 ,2例陈旧性骨折为 15～ 2 2周。术后均获随访 6～ 36个月。无感染、畸形愈合、骨不连、关节僵硬及再骨折等并发症。按 Kolmert等功能评定标准 ,优 19例 ,良 3例 ,可 1例 ,优良率 95 .7%。　结论　自动加压防旋髓内钉设计合理 ,生物力学性能稳定 ,临床应用操作简便 ,手术时间短 ,骨折愈合快 ,具有轴向加压及防旋功能。Objective To design an auto-compressive and anti-circumrotate intramedullary nail( ACACIN) and to evaluate the preliminary clinical efficacy on fixing adult femur fracture. Methods From January 1998 to June 2001, 23 patients with femur fracture were stabilized with auto-compressive and anti-circumrotate intramedullary nail. 2-4 elastic blocks were installed into the proximal and distal different distance of quincunx nail to defend circumrotate and axis compress. Results Fracture healing were obtained in all 23 patients treated with auto-compresseive and anti-circumrotate intramedullary nail, the time of fracture healing was 6 - 13 weeks in 21 cases and 15-22 weeks in 2 cases of old fracture. There was no complication related to infection, nail break, abnormal union and joint ankylosis. The results were excellent in 19 cases, good in 3 cases, and moderate in 1 case according Kolmert's criterion for function ; the effective rate was 95.7%. Conclusion Auto-compressive and anti-circumrotate intramedullary nail has a suitable radian for adult femur, can afford stable fixation, anti-circumrotate and axis compress.

关 键 词：自动加压防旋髓内钉 研制 股骨中下段骨折 修复 治疗 

分 类 号：R683.42[医药卫生—骨科学] R687.33[医药卫生—外科学]