Zanasi R, Rotolo F, Romano P, Galmarini V, Zanasi L
Ospedale Fatebenefratelli e Oftalmico, Divisione di Ortopedia e Traumatologia, Milano.
Ital J Orthop Traumatol. 1990 Jun;16(2):143-57.
Based on more than 20 years experience, the authors support the effectiveness of intramedullary nailing in the treatment of diaphyseal fractures of the femur. They review the history and advantages of this method and discuss the biomechanical principles on which it is based. Recent advances in technique have made it possible to secure proximal and distal anchorage in cancellous bone. This allows the method to be extended to more proximal and distal fractures than in the traditional method which is applicable only to the middle third. It also facilitates progressive axial compression, early loading and early mobilisation of the limb, thus creating the optimum biological conditions for consolidation and joint function. The closed method also reduces blood loss and the risk of infection. The techniques adopted to deal with more complex situations are described. These include moderately comminuted oblique and spiral fractures and certain bifocal fractures. Finally, the results of treating 450 cases are reviewed, with a longterm analysis of 198 patients.
基于20多年的经验，作者支持髓内钉治疗股骨干骨折的有效性。他们回顾了该方法的历史和优势，并讨论了其基于的生物力学原理。技术上的最新进展使得在松质骨中实现近端和远端固定成为可能。这使得该方法能够应用于比传统方法更多的近端和远端骨折，传统方法仅适用于中段三分之一。它还便于进行渐进性轴向加压、早期负重和肢体早期活动，从而为骨折愈合和关节功能创造最佳生物学条件。闭合手术方法还减少了失血量和感染风险。文中描述了处理更复杂情况所采用的技术。这些情况包括中度粉碎性斜形和螺旋形骨折以及某些双焦点骨折。最后，回顾了450例病例的治疗结果，并对198例患者进行了长期分析。
