Sadagatullah A N, Nazeeb M N, Ibrahim S
Department of Orthopaedics, Universiti Sains Malaysia, Kubang Kerian, Malaysia.
Department of Orthopaedics, Hospital Sultan Ismail, Johor Bahru, Malaysia.
Malays Orthop J. 2017 Nov;11(3):31-35. doi: 10.5704/MOJ.1711.013.
Osteosynthesis of the femur using an interlocking nail is the gold standard for treating diaphyseal fractures of the femur. There are two established entry points for the antegrade interlocking nails which is the piriformis fossa or the greater trochanter. It has been reported that varus malalignment was frequently seen in proximal femur fracture which were treated with interlocking nail utilizing the greater trochanter entry point. The study was done to find out if the problem was of significance. This was a retrospective study which included 179 patients with femur fractures which were treated from January 2013 till September 2015 in one Hospital. They were treated with interlocking nail either by utilizing the piriformis fossa (PF) or the greater trochanter (GT) entry points. Post-operative radiographs of the femur were used to measure the varus deformity. Out of 179 patients, there were 5 patients who were reported to have unacceptable varus malalignment (2.79%). These 5 patients were out of the 88 (5.68%) patients utilizing the greater trochanter as the entry point. The same 5 patients were out 90 patients that were diagnosed with proximal femur shaft fractures (5.55%). Analysis with logistic regression was statistically not significant. There was higher rate of varus malalignment seen in proximal femur shaft fractures treated with interlocking nails utilizing the greater trochanter entry point. The incidence of varus malalignment was not significant statistically.
使用带锁髓内钉对股骨进行骨固定术是治疗股骨干骨折的金标准。顺行带锁髓内钉有两个既定的进针点，即梨状窝或大转子。据报道，在使用大转子进针点的带锁髓内钉治疗的股骨近端骨折中，内翻畸形很常见。本研究旨在确定该问题是否具有显著性。这是一项回顾性研究，纳入了2013年1月至2015年9月在一家医院接受治疗的179例股骨骨折患者。他们采用梨状窝（PF）或大转子（GT）进针点使用带锁髓内钉进行治疗。术后股骨的X线片用于测量内翻畸形。在179例患者中，有5例报告存在不可接受的内翻畸形（2.79%）。这5例患者来自以大转子为进针点的88例患者（5.68%）。这5例患者也在90例被诊断为股骨近端骨干骨折的患者中（5.55%）。逻辑回归分析在统计学上无显著性差异。使用大转子进针点的带锁髓内钉治疗的股骨近端骨干骨折中，内翻畸形的发生率较高。内翻畸形的发生率在统计学上不显著。
