摘要
目的探讨带锁髓内钉治疗股骨干骨折失败的原因及其预防措施。方法回顾性分析本院2000年1月～2007年8月76例采用带锁髓内钉治疗股骨干骨折患者的临床资料,发生并发症12例,内固定失败6例。结果并发症有术中股骨颈骨折2例,肺栓塞1例,术后感染1例,大粗隆部疼痛2例,膝外翻2例,膝关节活动障碍2例,骨折端再骨折1例,骨不连1例;内固定失败按失败原因可分为主钉断裂2例,远端锁钉退出1例,膝关节纤维性强直2例;迟发感染1例。手术技术、手术适应证选择、康复锻炼的规范性、髓内钉的强度及合适与否是导致失败的相关原因。结论应用带锁髓内钉治疗股骨干骨折应掌握好适应证,强调术前准备充分,术中操作规范,术后锻炼应循序渐进,避免过早负重,是减少或防止内固定失效及并发症的重要措施。
Objective To analyze the failure factors and common complication of treating femoral shaft fracture with interlocking intramedullary nailing,and to offer the measures for prevention. Methods From January 2000 to August 2007,76 cases of femoral shaft fracture treated by interlocking intramedullary nailing were retrospectively analysed. 6 cases were failed and 12 cases showed complication. Results The failure cases were divided into 4 types：2 cases with nail break down, 1 case with proximal screw backing out,2 with fibrous ankylosis of knee, 1 with late infection. The complication cases were divided into 4 types： 2 cases with transcervical fracture, 1 cases with pulmonary embolism, 1 cases with postoperative infection,2 cases with tuberositas pain,2 cases with cross-knee,2 cases with articulatio genus motion obstacle. Failure relative factors were regarded to operation technique,incorrect rehabilitation choice of operative indication,quality of interlocking intramedullary nailing. Conclusion An appropriate indication should be chosen as using interlocking intramedullary nailing for femoral shaft fracture. The skills should be mastered well. The suitable materials should be chosen carefully and the rehabilitation exercises should be directed properly. All these are important measures for preventing failure factors and common complications. It＇s worthy to be used in dinic.
出处
《中国现代医生》
2008年第32期20-22,共3页
China Modern Doctor
关键词
股骨干骨折
内固定器
临床分析
Femoral fracture
Internal fixators
Clinical analysis
