Kurdy N M, Kay P R, Paul A S, Porter M L, Rae P J, Galasko C S
Orthopaedic Department, Hope Hospital, Salford, England.
Clin Orthop Relat Res. 1995 Jul(316):214-20.
A Huckstep intramedullary nail was used to treat 23 fractures in which the femur was mechanically deficient due to pathologic fracture, nonunion, or complex fracture in osteoporotic bone. All nailings were performed by open surgery, and in some cases this was augmented by corticocancellous bone grafting. The Huckstep nail allows the use of multiple cross screws at 15-mm intervals, providing immediate and adequate stability with successful early postoperative weightbearing. The results at followup were good in functional and radiologic terms, with no cases of fixation failure or infection. The quality of instrumentation allowed the nail and screws to be inserted without difficulty; however, the straight profile of the nail may cause problems in the distal femur, as seen in 1 patient. The authors conclude that this device offers significant mechanical and practical advantages over most other forms of fixation, where early weightbearing is desired in the presence of deficient bone. It is not ideal for distal femoral fractures, particularly in the presence of excessive femoral bowing.
采用哈克斯特普髓内钉治疗23例因病理性骨折、骨不连或骨质疏松性骨复杂骨折导致股骨力学性能不足的骨折。所有髓内钉固定均通过开放手术进行，在某些情况下还辅以皮质松质骨移植。哈克斯特普髓内钉允许以15毫米的间隔使用多根交叉螺钉，提供即时且足够的稳定性，术后早期即可成功负重。随访结果在功能和影像学方面均良好，无内固定失败或感染病例。器械的质量使得髓内钉和螺钉能够顺利插入；然而，如1例患者所示，髓内钉的直形轮廓可能会在股骨远端引起问题。作者得出结论，在骨量不足且期望早期负重的情况下，该器械相对于大多数其他固定形式具有显著的力学和实际优势。它对于股骨远端骨折并不理想，尤其是在股骨过度弯曲的情况下。
