Bekmezci Taner, Baca Emre, Kaynak Hakan, Kocabaş Rifat, Tonbul Murat, Yalaman Okan
Department of Orthopedics and Traumatology (Ortopedi ve Travmatoloji Kliniği), Okmeydani Training and Research Hospital, Istanbul, Turkey.
Acta Orthop Traumatol Turc. 2006;40(1):1-5.
We evaluated the use of expandable intramedullary nails, their efficacy, and short-term results in the treatment of femur shaft fractures.
The study included 20 patients (10 females, 10 males; mean age 31 years; range 15 to 75 years) who were treated with expandable intramedullary nails (Fixion intramedullary femur nail) for femur shaft fractures. All the fractures were closed and were rated as type 32 A or B according to the AO classification. The mean duration from injury to surgery was three days (range 4 hours to 8 days). The results were evaluated using the Thoresen criteria. The mean follow-up was 26 months (range 9 to 38 months).
The mean operation time was 79 minutes (range 45 to 120 min). Union was achieved in all the patients in a mean of 12.8 weeks (range 10 to 20 weeks). According to the Thoresen criteria, the results were excellent in 15 patients, good in one patient, fair in three patients, and poor in one patient. The results in all type A middle diaphyseal fractures were excellent. Of four patients with A2-3 distal metadiaphyseal fractures, one patient had a good result with a valgus of 5 degrees , and three patients had a fair result with a valgus ranging from 8 degrees to 10 degrees , one of which also had 8-mm shortening. Delayed union, early or late infections, compartment syndrome, or bone necrosis were not seen. Of six patients who completed a follow-up of two years, the nails were removed in five patients, whereas removal was not possible in one patient due to a break in the upper part.
Expandable intramedullary nails offer advantages in terms of ease of application and are less invasive than static nails and reamed applications. However, they may not provide adequate stability in metadiaphyseal regions and in fractures with fragments greater than 50%.
我们评估了可膨胀髓内钉的使用情况、其疗效以及治疗股骨干骨折的短期结果。
该研究纳入了20例患者（10名女性，10名男性；平均年龄31岁；年龄范围15至75岁），这些患者因股骨干骨折接受了可膨胀髓内钉（Fixion股骨髓内钉）治疗。所有骨折均为闭合性骨折，根据AO分类法评为32 A或B型。受伤至手术的平均时长为3天（范围4小时至8天）。使用托勒森标准对结果进行评估。平均随访时间为26个月（范围9至38个月）。
平均手术时间为79分钟（范围45至120分钟）。所有患者均在平均12.8周（范围10至20周）实现骨折愈合。根据托勒森标准，15例患者结果为优，1例为良，3例为可，1例为差。所有A型中骨干骨折的结果均为优。在4例A2 - 3型远侧干骺端骨折患者中，1例结果为良，外翻5度，3例结果为可，外翻8度至10度，其中1例还有8毫米短缩。未出现骨延迟愈合、早期或晚期感染、骨筋膜室综合征或骨坏死。在6例完成两年随访的患者中，5例取出了髓内钉，而1例因上部断裂无法取出。
可膨胀髓内钉在应用简便性方面具有优势，且比静态髓内钉和扩髓应用的侵入性更小。然而，它们在干骺端区域以及骨折块大于50%的骨折中可能无法提供足够的稳定性。
