Cilli Feridun, Mahiroğullari Mahir, Pehlivan Ozcan, Keklikçi Kenan, Kuşkucu Mesih, Kiral Ahmet, Avşar Serdar
Department of Orthopaedics and Traumatology, GATA Haydarpaşa Training Hospital, Istanbul, Turkey.
Ulus Travma Acil Cerrahi Derg. 2009 Jul;15(4):383-9.
Femoral shaft fractures are usually seen in the young population as a result of high energy traumas and are often accompanied by major organ injuries. In this paper, we aimed to assess the clinical results of expandable femoral intramedullary nails in the treatment of 20 femoral shaft fractures.
The average age was 34.7. One fracture was the result of a gunshot wound, type 3A open fracture, and the other 19 fractures were closed. Under fluoroscopic control, all patients underwent elective closed reduction and internal fixation with intramedullary expandable femoral nails (Fixion, Disc-O-Tech; Israel). In case of failed or unacceptable closed reduction, open reduction was achieved with a second incision over the fracture site. Average operation time was 26.3 minutes.
Full union was achieved in all patients. The shortest union time was 12 weeks and the longest 24 weeks, with an average of 15.2 weeks. Results in 15 patients (75%) were excellent, in 4 patients (20%) good and in 1 patient (5%) moderate according to Thorensen criteria.
Use of expandable nails provides union without major complications and offers advantages such as less exposure to radiation as seen in distal locking of classical intramedullary nails. In conclusion, the good results of this study show that the expandable femoral intramedullary nail provides a successful option to classical intramedullary nails.
股骨干骨折常见于年轻人群,多由高能量创伤所致,常伴有主要器官损伤。本文旨在评估可膨胀股骨髓内钉治疗20例股骨干骨折的临床效果。
平均年龄34.7岁。1例骨折为枪伤所致,3A型开放性骨折,其余19例为闭合性骨折。在透视控制下,所有患者均接受了选择性闭合复位,并使用股骨髓内可膨胀钉(Fixion,Disc-O-Tech;以色列)进行内固定。若闭合复位失败或不可接受,则在骨折部位做第二个切口进行切开复位。平均手术时间为26.3分钟。
所有患者均实现了完全愈合。最短愈合时间为12周,最长为24周,平均为15.2周。根据Thorensen标准,15例患者(75%)结果为优,4例患者(20%)为良,1例患者(5%)为中。
使用可膨胀钉可实现骨折愈合且无重大并发症,具有一些优势,如与传统髓内钉远端锁定相比,辐射暴露较少。总之,本研究的良好结果表明,可膨胀股骨髓内钉为传统髓内钉提供了一种成功的选择。