[交锁髓内钉治疗股骨干骨折失败因素分析]
[An analysis of failure factors in treatment of femoral shaft fracture with interlocking intramedullary nailing].
作者信息
Li Guang-hui, Li Feng, Xia Ren-yun, Wang Ti-pei, Chen An-min
机构信息
Department of Orthopaedics, Tongji Hospital, Tongji Medical College, Huazhong Science and Technology University, Wuhan 430030, China.
出版信息
Zhonghua Wai Ke Za Zhi. 2006 Apr 15;44(8):538-40.
OBJECTIVE
To analyze the failure factors treating femoral shaft fracture with interlocking intramedullary nailing, and to offer the measures for prevention.
METHODS
From April 1999 to September 2002, among the 213 cases of femoral shaft fracture treated by interlocking intramedullary nailing, 18 were failure. The data of these cases were analyzed.
RESULTS
The failure cases were divided into 6 types: 3 cases with nail break-down, 7 with distal screw backing out, 3 with proximal screw backing out, 3 with fibrous ankylosis of knee, 2 with late infection. Failure relative factors were regarded to operation technique, incorrect rehabilitation choice of operative indication, quality of interlocking intramedullary nailing.
CONCLUSIONS
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 prevention.
目的
分析带锁髓内钉治疗股骨干骨折的失败因素，并提出预防措施。
方法
1999年4月至2002年9月，在213例采用带锁髓内钉治疗的股骨干骨折患者中，18例治疗失败。对这些病例的数据进行分析。
结果
失败病例分为6种类型：3例髓内钉断裂，7例远端螺钉退出，3例近端螺钉退出，3例膝关节纤维性强直，2例迟发性感染。失败相关因素被认为与手术技术、手术适应证选择不当、带锁髓内钉质量有关。
结论
采用带锁髓内钉治疗股骨干骨折时应选择合适的适应证。应熟练掌握技术。应谨慎选择合适的材料。并且应正确指导康复锻炼。所有这些都是重要的预防措施。
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