InterTan髓内钉治疗股骨转子间骨折的初步疗效分析

摘要

Objective To report the clinical results of InterTan nail, a new generation of intermedullary locking nail, used for the treatment of intertrochanteric fractures. Methods 11 patients with an intertrochanteric fracture were treated with Intertan. Their surgical data, modified Harris hip score, X-radiographs, uniontime and complications were analyzed retrospectively. Results The average operation time was 110±21 minutes, and the average intraoperative blood loss was 127±134 ml. Except one patient died .all the last 10 patients were followed up. Fractures healed within an average of 3.7±1.3 months. By the modified Harris hip score, 80% of the patients recovered their prefracture status. Radiographic analysis at healing revealed no loss of reduction, no uncontrolled collapse of the neck, no nonunions, no femoral shaft fractures, and no implant failures. Conclusion InterTan nail, a new generation of intermedullary locking nail, with the special design of 2 integrated screws using a worm gear mechanism to achieve linear compression; an intramedultary implant with a trapezoidal proximal stem; a large ＜ 15.5 mm )oval footprint within the head and neck fragment and maintenance of intraoperative reduction during implant insertion, can improved the clinical outcoms of intertrochanteric fractures.%目的 评价新型股骨近端髓内钉InterTan治疗股骨转子间骨折的初步疗效.方法 回顾性分析11例采用InterTan髓内钉治疗股骨转子间骨折的病例,按Evans-Jensen分类,其中IB型3例,ⅡA型2例,ⅡB型5例,Ⅲ型1例.分析患者的手术时间、术中出血情况、随访患者的骨折愈合及术后并发症等情况,并采用改良髋关节Harris 评分系统评估髋关节功能恢复情况.结果 平均手术时间110±21分钟,术中出血127±134ml,除1例患者死亡外,10例患者均获随访.10例患者骨折均获愈合,平均愈合时间为3.7±1.3个月.80％患者髋关节功能恢复到受伤前状态.术后3个月以上摄片未见股骨头切割,股骨颈短缩,髋内翻、股骨干骨折及内置物松动、断裂等并发症发生.结论新代股骨近端髓内钉InterTan主钉的近端梯形结构、股骨颈双螺钉组合成卵圆形结构、股骨颈双螺钉轴向加压等独特设计有效地提高了临床治疗股骨转子间骨折的效果.