Papineau L J, Lemieux R, Mehio Z
Can J Surg. 1980 May;23(3):252-5.
The results of 104 patients with fractures of the femoral shaft treated, from 1969 to 1973 at the hôpital du Sacré-Coeur in Montreal, by insertion of a large Küntscher nail alone were compared with those in 70 patients whose femoral shaft fractures were treated, from 1960 to 1975 at the hôpital Notre-Dame in Montreal, with a small Küntscher nail and an autologous iliac graft. Use of a large Küntscher nail without bone grafting gave good results in the majority of patients. Excessive reaming, however, diminished the area of contact between the fragments and prolonged the healing time. Refracture occurred more often. The average length of time for consolidation in nongrafted fractures was found to be equal to the maximum time for grafted fractures (i.e., 16 weeks). A small Küntscher nail with an autologous iliac bone graft could be used safely in fractures of the lower third and in the subtrochanteric region of the femur. Grafting produces earlier healing and weight bearing. The hypertrophic callus protects against refracture.
1969年至1973年期间，在蒙特利尔圣心医院对104例股骨干骨折患者仅通过插入一枚大型克氏针进行治疗，其结果与1960年至1975年期间在蒙特利尔圣母医院对70例股骨干骨折患者采用小型克氏针及自体髂骨移植治疗的结果进行了比较。对大多数患者而言，使用大型克氏针而不进行骨移植可取得良好效果。然而，过度扩髓会减少骨折碎片之间的接触面积并延长愈合时间，骨折再发更为常见。结果发现，未植骨骨折的平均愈合时间与植骨骨折的最长愈合时间相同（即16周）。小型克氏针联合自体髂骨移植可安全用于股骨下三分之一段及转子下区域的骨折。植骨可实现更早愈合及负重，肥厚的骨痂可预防骨折再发。
