Matsugaki Toru, Mizu-Uchi Hideki, Aratake Yuji, Yasumoto Keitarou
Department of Orthopaedic Surgery, Kurume University Hospital.
Department of Orthopaedic Surgery, Saiseikai Fukuoka General Hospital.
Kurume Med J. 2025 Aug 1;71(1.2):37-41. doi: 10.2739/kurumemedj.MS7112005. Epub 2024 Nov 27.
The purpose of this study was to investigate the effect of the main fragment fracture type (oblique or transverse) on the union rate of femoral shaft fractures.
Patients who underwent surgical treatment with an antegrade intramedullary nail for femoral shaft fracture (Arbeitsgemeinschaft für Osteosynthesefragen / Orthopaedic Trauma Association; AO/OTA type 32 type B or C) between January 2009 and March 2021 were included in this study. Patients with oblique fractures of the two main fragments on radiographs immediately after surgery were classified into the oblique fracture group. Patients with at least one of the two main fractures being transverse fractures were classified into the transverse fracture group. We investigated age, sex, height, weight, body mass index (BMI), AO/OTA classification, time from fracture to surgery, intramedullary nail length and diameter, number of interlocking screws, and bone union rate.
A total of 55 fractures were included. The mean age was 34.4 ± 16.7 (range, 16-77) years. There were 41 fractures classified into the oblique fracture group and 14 fractures classified into the transverse fracture group. There was a significantly higher proportion of men in the transverse fracture group. Patients in the transverse fracture group were significantly younger and taller. Only 1 of 41 (2.4%) patients in the oblique group experienced nonunion, while 3 of 14 (21.4%) patients in the transverse group experienced nonunion (p = 0.030).
Comminuted femoral shaft fractures with transverse fracture components are more prone to nonunion.
本研究旨在探讨主要骨折块骨折类型（斜形或横行）对股骨干骨折愈合率的影响。
纳入2009年1月至2021年3月期间采用顺行髓内钉治疗股骨干骨折（ Arbeitsgemeinschaft für Osteosynthesefragen / 骨科创伤协会；AO/OTA 32-B型或C型）的患者。术后X线片显示两个主要骨折块为斜形骨折的患者被分类到斜形骨折组。两个主要骨折块中至少有一个为横行骨折的患者被分类到横行骨折组。我们调查了年龄、性别、身高、体重、体重指数（BMI）、AO/OTA分类、骨折至手术的时间、髓内钉长度和直径、交锁螺钉数量以及骨愈合率。
共纳入55例骨折患者。平均年龄为34.4±16.7（范围16-77）岁。斜形骨折组有41例骨折，横行骨折组有14例骨折。横行骨折组男性比例明显更高。横行骨折组患者明显更年轻、更高。斜形骨折组41例患者中只有1例（2.4%）发生骨不连，而横行骨折组14例患者中有3例（21.4%）发生骨不连（p = 0.030）。
伴有横行骨折块的粉碎性股骨干骨折更易发生骨不连。
