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[应用恩德尔(Ender)法行股骨转子间骨折闭合髓内针固定时股骨颈的自动内翻]

[Automatic retroversion of the femur neck during fasciculated nailing of pertrochanteric fractures by the Ender method].

作者信息

Teinturier P, Levai J P, Fabre J L, Terver S, Jaramillo V

出版信息

Int Orthop. 1984;8(1):13-7. doi: 10.1007/BF00267734.

Abstract

The shape of the standard Ender nail may result in malunion in external rotation in intertrochanteric fractures treated with this device. The nail is curved in one plane, and is usually introduced into the femur without making allowance for the bowing of the diaphysis and the anteversion present in the neck. We have measured radiographically the anteversion of the femoral neck in three groups of patients after operation using Ender nails, and also assessed the anteversion of the unoperated hip for comparison. In Group I normal Ender nails were used. The operated hip showed an average of 12 degrees of retroversion compared with the opposite side. In Group II the nails were bent anteriorly at their upper end, but an average retroversion of 14 degrees was produced compared with the other hip. In Group III the nails were bent to produce anterior bowing as well as proximal anteversion. The group showed retroversion of only 1 degree compared with the normal side. We therefore recommend that Ender nails be bent in this manner in order to reduce rotatory malunion when used for intertrochanteric fractures of the neck of the femur.

摘要

标准的恩德勒髓内钉的形状可能会导致使用该器械治疗的股骨转子间骨折出现外旋畸形愈合。髓内钉在一个平面上呈弯曲状,通常在插入股骨时未考虑骨干的弯曲和股骨颈存在的前倾情况。我们对三组使用恩德勒髓内钉手术后的患者进行了股骨颈前倾的影像学测量,并评估了未手术髋关节的前倾情况以作比较。第一组使用标准的恩德勒髓内钉。与对侧相比,手术侧髋关节平均出现了12度的后倾。第二组髓内钉在其上端向前弯曲,但与另一侧相比仍产生了平均14度的后倾。第三组髓内钉被弯曲以产生向前的弓形以及近端前倾。与正常侧相比,该组仅出现了1度的后倾。因此,我们建议在用于股骨颈转子间骨折时,将恩德勒髓内钉按此方式弯曲,以减少旋转畸形愈合。

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