| 曾云浩,刘阳,黄创,等.股骨髓内钉联合肱骨近端锁定钢板治疗股骨转子下骨折不愈合.骨科,2024,15(6): 519-523. |
| 股骨髓内钉联合肱骨近端锁定钢板治疗股骨转子下骨折不愈合 |
| Intramedullary Nailing of the Femur Combined with Proximal Humeral Internal Locking System in the Treatment of Non-union of Subtrochanteric Femur Fracture |
| 投稿时间：2024-07-02 |
| DOI：10.3969/j.issn.1674-8573.2024.06.007 |
| 中文关键词: 股骨转子下骨折 骨不连 股骨髓内钉 肱骨近端锁定接骨板 |
| 英文关键词: Subtrochanteric femur fracture Fracture non-union Femoral intramedullary nail Proximal humeral internal locking system |
| 基金项目:湖北省科技创新专项（2021CFB350） |
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| 中文摘要: |
| 目的 探讨应用股骨髓内钉结合肱骨近端锁定钢板系统（proximal humeral internal locking system，PHILOS）治疗股骨转子下骨不连的临床效果。方法 对2020年6月至2023年6月在我院治疗的11例股骨转子下骨不连的病例进行回顾性分析，男6例，女5例，年龄为（57.27±8.19）岁（45~69岁）。按照Seinsheimer划分标准，Ⅱ型骨折2例，Ⅲ型骨折3例，Ⅳ型骨折5例，Ⅴ型骨折1例。初次手术至再次手术的时间为（14.09±2.07）个月（12~18个月）。病人均采用股骨髓内钉与PHILOS手术治疗并辅以自体髂骨植骨。术后采用X线片和CT评价骨折愈合情况，以及依据Harris髋关节评分系统评估病人功能恢复情况。结果 随访期间，所有病人的骨折均顺利愈合，骨折愈合时间为（18.64±3.85）周（12~24周），未出现植入物引发的感染或内固定装置失效。根据Harris髋关节功能评分，优7例，良3例，可1例，优良率为90.91%。结论 使用股骨髓内钉联合PHILOS治疗股骨转子下骨不连，稳定性较好，可有效避免内固定失效，术后功能恢复良好。 |
| 英文摘要: |
| Objective To explore the efficacy of employing femoral intramedullary nailing in conjunction with proximal humeral anatomical plate fixation for the management of non-union in subtrochanteric femur fractures. Methods A retrospective analysis was conducted on 11 cases of femoral intertrochanteric non-union treated in our hospital from June 2020 to June 2023, including 6 males and 5 females, aged (57.27±8.19) years (45-69 years). According to the Seinsheimer classification criteria, there were 2 cases of type Ⅱ fractures, 3 cases of type Ⅲ fractures, 5 cases of type Ⅳ fractures, and 1 case of type V fractures. The time from the first surgery to the second surgery was (14.09±2.07) months (12-18 months). All patients were treated with femoral intramedullary nail and PHILOS surgery, supplemented by autologous iliac bone grafting. The fracture healing was postoperative evaluated using X-rays and CT, and patient functional recovery was assessed using the Harris hip joint scoring system. Results During the follow-up period, all patients' fractures healed smoothly, with a healing time of (18.64±3.85) weeks (12-24 weeks). There were no infections caused by implants or failures of internal fixation devices. According to the Harris hip joint function score, there were 7 cases of excellent effectiveness, 3 cases of good effectiveness, and 1 case of fair effectiveness, with an excellent and good rate of 90.91%. Conclusion The use of femoral intramedullary nail combined with PHILOS for the treatment of femoral intertrochanteric non-union has good stability, can effectively avoid internal fixation failure, and has good postoperative functional recovery. |
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