Hooper G J, Lyon D W
Christchurch School of Medicine, New Zealand.
J Bone Joint Surg Br. 1988 Aug;70(4):619-21. doi: 10.1302/0301-620X.70B4.3403610.
Fifty consecutive comminuted fractures of the femoral shaft were treated by closed unlocked intramedullary nailing. Twelve unstable fractures also had cast-bracing. There were no cases of infection or non-union, and satisfactory results were achieved in 38 fractures (76%). More severe comminution led to a higher incidence of unsatisfactory results, but malrotation deformity was seen more often in less comminuted fractures and appeared to be due to poor operative reduction. Shortening in severe comminution was the main complication and was not controlled by supplementary cast-bracing. Closed unlocked intramedullary nailing is effective for lesser grades of comminution, but fractures with no cortical continuity at reduction should be treated with a locking nail.
采用闭合非锁定髓内钉治疗50例连续股骨干粉碎性骨折。12例不稳定骨折还采用了石膏外固定。无感染或骨不连病例，38例骨折（76%）取得满意效果。粉碎程度越严重，效果不满意的发生率越高，但在粉碎程度较轻的骨折中，旋转畸形更常见，似乎是由于手术复位不佳所致。严重粉碎性骨折的短缩是主要并发症，补充石膏外固定无法控制。闭合非锁定髓内钉对较轻程度的粉碎有效，但复位时无皮质连续性的骨折应采用锁定髓内钉治疗。
