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相關文獻
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頁籤選單縮合
題名 | Primary Reamed Intramedullary Nailing of Closed Femoral Shaft Fractures=擴腔骨髓內釘療法治療閉鎖性股骨幹骨折 |
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作者 | 陳金恩; 劉浩誠; Chen, Chin-en; Liu, Hao-chen; |
期刊 | 中華民國急救加護醫學會雜誌 |
出版日期 | 19990300 |
卷期 | 10:1 1999.03[民88.03] |
頁次 | 頁19-28 |
分類號 | 416.26 |
語文 | eng |
關鍵詞 | 股骨幹骨折; 骨髓內釘; Femoral shaft fracture; Intramedullary nailing; |
中文摘要 | 自1993至1996我們收集了47例以閉鎖式骨髓內釘治療閉鎖性股骨幹骨折的病例,所有病例最少追蹤一年。大部份病例為機車意外造成,其中17例為不穩定骨折。所有病人均以平躺姿式治療。46例得到癒合,平均骨折癒合時間為18週,癒合率為97.8%。手術後合併症包括一例急性腔室症候群及兩例暫時性坐骨神經功能失常,一例骨折不癒合。但沒有感染病例發生,也沒有病例有明顯長短腿及旋轉變形。以閉鎖式骨髓內釘治療股骨幹骨折擴腔時的骨髓可促進骨折癒合,使用互鎖式骨髓內釘可避免長短腿及彎曲的變形,但是過度的擴腔似乎沒有其必要性,為避免坐骨神經受傷,手術前可給予較重的骨骼牽引以減少手術中因復位困難而需要強烈的牽引。這種技術通常需要較有經驗的醫師來執行。由治療的結果我們認為以閉鎖式骨髓內釘治療閉鎖性股骨幹骨折是一種相當安全有效的治療方式。 |
英文摘要 | Between 1993 and 1996, 47 closed femoral shaft fractures in 46 patients were treated with closed intramedullary nailing by the authors at our hospital. All of the patients were operated in a supine position. Forty-six of the 47 fractures united on average after 18 weeks (range 12 to 32 weeks). The union rate was 97.8 percent. Postoperative complications included acute compartment syndrome in one patient and transient sciatic nerve palsy in two patients. Atrophic nonunion of the femoral shaft was noted in one case which was treated with exchange nailing. There are many advantages in closed femoral nailing, especially reaming cancellous bone grafting which can promote the bony healing. The use of a static interlocking nail for unstable comminuted fractures prevents the risk of shortening and angulation deformity. Strong preoperative traction followed by accurate positioning of the patient on the operating table or distal femoral skeletal traction used in cases where strong traction is required during the operation may prevent the complication of sciatic nerve palsy. Extensive reaming to place a larger nail is unnecessary. This technique demands an experienced surgeon, however. The successful results imply that closed femoral nailing is a safe and effective method for closed femoral shaft fractures. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。