Crist Brett D, Dart Bradley R, Czuwala Peter J, Olney Brad W, Pence Charles D
Orthopaedic Surgery Residency Program, University of Missouri-Columbia, Department of Orthopaedic Surgery, One Hospital Drive, MC213 Columbia, MO 65212, USA.
Am J Orthop (Belle Mead NJ). 2006 Jan;35(1):37-41.
Intramedullary fixation as a treatment for adolescent femur fractures has increased in popularity. We investigated the varus stability of 3 fixation techniques--the standard 2-nail configuration (2 retrograde nails), a 3-nail configuration (standard 2-nail configuration plus 1 antegrade nail), and a retrograde/antegrade 2-nail configuration--in synthetic femurs with 2 simulated fracture patterns (transverse, butterfly). A varus moment was applied to the specimens until 20 degrees of varus angulation was obtained. The varus angular stiffness of the construct defined varus stability. The 3-nail configuration had the most varus angular stiffness with both fracture patterns. The varus stability of the 3-nail configuration was statistically higher than that of the standard 2-nail configuration with the transverse fracture pattern only. Adding 1 antegrade nail to 2 retrograde nails significantly increased resistance to varus deformity of reduced proximal-third transverse femur fractures in the synthetic femur model.
髓内固定作为青少年股骨骨折的一种治疗方法，其应用越来越普遍。我们研究了三种固定技术——标准双钉构型（2枚逆行钉）、三钉构型（标准双钉构型加1枚顺行钉）和逆行/顺行双钉构型——在具有两种模拟骨折模式（横行、蝶形）的合成股骨中的内翻稳定性。向标本施加内翻力矩，直至获得20度的内翻成角。构建体的内翻角刚度定义为内翻稳定性。对于两种骨折模式，三钉构型具有最大的内翻角刚度。仅在横行骨折模式下，三钉构型的内翻稳定性在统计学上高于标准双钉构型。在合成股骨模型中，在2枚逆行钉上加1枚顺行钉可显著增加对近端三分之一横行股骨骨折复位后内翻畸形的抵抗力。
