摘要
[目的]探讨股骨上段复杂骨折的最佳内固定方法。[方法]治疗52例（54肢）股骨上段复杂骨折，均采取开放复位内固定。应用交锁髓内钉治疗成人骨折32例（34肢）和130°角钢板治疗儿童骨折20例。闭合性骨折36肢，开放性骨折18肢。采用自体髂骨植骨5肢和同种异体骨植骨10肢。[结果]术后随访9～40个月，平均16个月。无伤口感染、骨不连、畸形愈合和股骨头坏死等并发症。成人和儿童平均骨I临床愈合时间分别为6．8个月和6．5个月。远期疗效按马元璋标准评定，肢体关节功能恢复优良率94．4％。[结论]根据患者年龄选择合适的内固定方法和术中精确的复位对提高股骨上段复杂骨折的疗效十分重要。交锁髓内钉用于成人和130°角钢板用于儿童是较为理想的选择。
[ Objective ] To investigate the best internal fixation methods of upper segment complicated femoral fractures （US- CFF）. [ Method] Fifty-two cases（ 54 limbs） with USCFF were treated. In all patients open fracture reduction with use of internal fixation were done. Intramedullary interlocking nails（IIN） were used to treat 32 cases（34 limbs） of adult＇s USCFF and 130° plate were used to treat 20 cases of children＇s USCFF. Thirty-six limbs of them were closed fractures, and 18 limbs were opene. Measures of auto-ilium transplant（ 5 limbs）, homolegous allograft bone transplant（ 10 limbs）were also taken. [ Result] Fifty-two patients were followed-up from 9 to 40 months with an average of 16 months. Infection, fracture nonunions, malunion and femoral head necrosis complications were not found. The average period of union of adult and children fractures was respectively 6.8 months and 6.5 months. The long term effect was evaluated according to Ma Yuanzhang＇s evaluation standard, 94.4 percent showed excellent function of joints and limbs. [ Conclusion] Appropriate selection of internal fixation according to the age of patients and satisfactory fracture reduction are key points to improve outcome of USCFF. IIN in treating fiacture of adult and 130° plate in treating fracture of children are more ideal selections.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2006年第4期252-253,287,共3页
Orthopedic Journal of China
关键词
股骨干
复杂骨折
成人
儿童
内固定
Femoral shaft
Complicated fracture
Adult
Children
Internal fixation
