髓内钉治疗股骨中下段骨折的并发症分析

doi:10.3760/cma.j.issn.1007-1245.2023.23.001

国际医药卫生导报 ›› 2023, Vol. 29 ›› Issue (23): 3321-3324.DOI: 10.3760/cma.j.issn.1007-1245.2023.23.001

• 医学新进展 • 下一篇

髓内钉治疗股骨中下段骨折的并发症分析

耿泽月张兴凯杜刚强周楠赵冬阳王志刚

滨州医学院附属医院创伤骨科，滨州　256603

收稿日期:2023-07-03 出版日期:2023-12-01 发布日期:2024-01-03
通讯作者: 王志刚，Email：wangzghn@163.com
基金资助:
山东省医药卫生科技发展计划项目（2017WS229、202004070551）

Complications of intramedullary nailing in the treatment of infra-isthmal femoral fracture

Geng Zeyue, Zhang Xingkai, Du Gangqiang, Zhou Nan, Zhao Dongyang, Wang Zhigang

Department of Orthopaedic and Traumatology, Binzhou Medical University Hospital, Binzhou 256603, China

Received:2023-07-03 Online:2023-12-01 Published:2024-01-03
Contact: Wang Zhigang, Email: wangzghn@163.com
Supported by:
Health Science and Technology Development Program of Shandong Province (2017WS229, 202004070551)

摘要/Abstract

摘要：

髓内钉目前已成为股骨中下段骨折的常见治疗方式，但不同类型的髓内固定方式在开口、置钉及预后随访过程中均存在一定的差异与问题。本文通过汇总关于采用顺行及逆行髓内固定治疗股骨中下段骨折的文献，并对文献中所提及的相关并发症及解决方案进行总结，意在为合适髓内固定方式的选择及相应并发症的避免提供参考。

关键词:

股骨中下段骨折, 髓内钉, 并发症, 内固定, 进展

Abstract:

Infra-isthmal femoral fracture is commonly treated with intramedullary nailing, but there are several variances and issues related to different intramedullary fixation strategies in terms of opening site, nail placement, and postoperative follow-up. This paper reviews the literatures on the use of paralleling and retrograde intramedullary fixation in the treatment of infra-isthmal femoral fracture and documents the complications and solutions mentioned to provide a reference for the selection of proper intramedullary fixation and minimizing the complications.

Key words:

Infra-isthmal femoral fracture, Intramedullary nail, Complications, Internal fixation, Progress

耿泽月张兴凯杜刚强周楠赵冬阳王志刚.

髓内钉治疗股骨中下段骨折的并发症分析 [J]. 国际医药卫生导报, 2023, 29(23): 3321-3324.

Geng Zeyue, Zhang Xingkai, Du Gangqiang, Zhou Nan, Zhao Dongyang, Wang Zhigang.

Complications of intramedullary nailing in the treatment of infra-isthmal femoral fracture [J]. International Medicine and Health Guidance News, 2023, 29(23): 3321-3324.

参考文献

[1] Kim JW, Oh CW, Oh JK, et al. Treatment of infra-isthmal femoral fracture with an intramedullary nail: Is retrograde nailing a better option than antegrade nailing?[J].Arch Orthop Trauma Surg,2018,138(9):1241-1247.DOI:10.1007/s00402-018-2961-6.
[2] 刘如月,郝玉梅. 交锁髓内钉与解剖锁定钢板固定术治疗股骨中下段骨折对膝关节功能的影响[J]. 国际医药卫生导报,2016,22(2):201-203.DOI:10.3760/cma.j.issn.1007-1245. 2016.02.019.
[3] Hussain N, Hussain FN, Sermer C, et al. Antegrade versus retrograde nailing techniques and trochanteric versus piriformis intramedullary nailing entry points for femoral shaft fractures: a systematic review and meta-analysis[J].Can J Surg,2017,60(1):19-29.DOI:10.1503/cjs.000616.
[4] Soylemez MS, Oz TT. Does using different entrance points for intramedullary nails affect clinical outcomes for femoral shaft fractures? A retrospective clinical comparative study[J].North Clin Istanb,2020,7(6):609-618.DOI:10.14744/nci.2020.08058.
[5] Ching M, Gee A, Del Balso C, et al. Biomechanical consequences of nail insertion point and anterior cortical perforation for antegrade femoral nailing[J].Biomed Res Int,2020,2020:5878607.DOI:10.1155/2020/5878607.
[6] Schottel PC, Hinds RM, Lazaro LE, et al. The effect of antegrade femoral nailing on femoral head perfusion: a comparison of piriformis fossa and trochanteric entry points[J].Arch Orthop Trauma Surg,2015,135(4):473-480.DOI:10.1007/s00402-015-2169-y.
[7] Elbarbary AN, Hassen S, Badr IT. Outcome of intramedullary nail for fixation of osteoporotic femoral shaft fractures in the elderly above 60[J].Injury,2021,52(3):602-605.DOI:10.1016/j.injury.2020.10.012.
[8] Yuan D, Wu Z, Luo S, et al. Improve biomechanical stability using intramedullary nails with femoral neck protection in femoral shaft fractures[J].Comput Methods Programs Biomed,2022,225:107078.DOI:10.1016/j.cmpb.2022.107078.
[9] Pawlak AC, Malik AN, Berliner Z, et al. Use of a retrograde guidewire to direct an antegrade femoral nail[J].Orthopedics,2023,46(2):e132-e135.DOI:10.3928/01477447-20221031-05.
[10] Scolaro JA, Endress C, Mehta S. Prevention of cortical breach during placement of an antegrade intramedullary femoral nail[J].Orthopedics,2013,36(9):688-692.DOI:10.3928/01477447-20130821-03.
[11] Engler ID, Sinz NJ, McIntyre JA, et al. Impingement and perforation of the anterior femoral cortex in cephalomedullary nailing: systematic review and surgical techniques[J].Orthop Traumatol Surg Res,2023,109(2):103505.DOI:10.1016/j.otsr.2022.103505.
[12] Yoon RS, Adams DM, Seigerman DA, et al. Impact of surrounding canal size on time to union after intramedullary nailing of femur fractures: are 10-mm nails all we need?[J].J Orthop Trauma,2020,34(4):180-185.DOI:10.1097/BOT.0000000000001670.
[13] Yang TC, Tzeng YH, Wang CS, et al. "Ratio of fracture site diameter to isthmus femoral canal diameter" as a predictor of complication following treatment of infra-isthmal femoral shaft fracture with antegrade intramedullary nailing[J].Injury,2021,52(4):961-966.DOI:10.1016/j.injury.2020.12.034.
[14] Neumayer F, Löcherbach C, McManus J, et al. Medial femoral condyle fracture as a complication of antegrade intramedullary nailing[J].Arch Orthop Trauma Surg,2013,133(9):1273-1279.DOI:10.1007/s00402-013-1796-4.
[15] Fantry AJ, Elia G, Vopat BG, et al. Distal femoral complications following antegrade intramedullary nail placement[J].Orthop Rev (Pavia),2015,7(1):5820.DOI:10.4081/or.2015.5820.
[16] Hung WC, Hsu CJ, Kumar A, et al. Perioperative radiographic predictors of non-union in infra-isthmal femoral shaft fractures after antegrade intramedullary nailing: a case-control study[J].J Clin Med,2022,11(13):3664.DOI:10.3390/jcm11133664.
[17] Issace SJJ, Singh RSJS, Sisubalasingam N, et al. Does obesity affect diaphyseal femoral fracture healing treated with intramedullary locking nail?[J].Jt Dis Relat Surg,2023,34(1):9-15.DOI:10.52312/jdrs.2023.649.
[18] Cvetanovich GL, Ukwuani G, Kuhns B, et al. Antegrade femoral nail distal interlocking screw causing rupture of the medial patellofemoral ligament and patellar instability[J].Am J Orthop (Belle Mead NJ),2018,47(7).DOI:10.12788/ajo.2018.0054.
[19] Levy Y, Feldman G, Weil YA, et al. An uncommon complication of arteriovenous fistula following intramedullary nail distal locking - a case report[J].J Orthop Case Rep,2021,11(10):83-86.DOI:10.13107/jocr.2021.v11.i10.2482.
[20] Hegde A, Mane PP, Sanman KN. Neglected broken femoral intramedullary nail resulting in an urethrocutaneous fistula[J].Indian J Orthop,2021,56(1):169-173.DOI:10.1007/s43465-021-00442-1.
[21] He M, Tian S, Liu J, et al. Imaging evaluation of insertion point accuracy in retrograde intramedullary femoral nailing[J].Biomed Res Int,2022,2022:6068490.DOI:10.1155/2022/6068490.
[22] 吕宇明,蒋云楼,罗国富. 顺行和逆行交锁髓内钉对股骨中下段骨折的疗效观察[J]. 当代医学,2019,25(20):50-51.DOI:10.3969/j.issn.1009-4393.2019.20.019.
[23] Wright DJ, DeSanto DJ, McGarry MH, et al. Nail diameter significantly impacts stability in combined plate-nail constructs used for fixation of supracondylar distal femur fractures[J].OTA Int,2022,5(1):e174.DOI:10.1097/OI9.0000000000000174.
[24] Albareda-Albareda J, Gabarre-Raso S, Rosell-Pradas J, et al. Biomechanical behavior of retrograde intramedullary nails in distal femoral fractures[J].Injury,2021,4:S76-S86.DOI:10.1016/j.injury.2021.01.052.
[25] Guo J, Zha J, Di J, et al. Outcome analysis of intramedullary nailing augmented with poller screws for treating difficult reduction fractures of femur and tibia: a retrospective cohort study[J].Biomed Res Int,2021,2021:6615776.DOI:10.1155/2021/6615776.
[26] Yakkanti R, Kitchen J, Voor M, et al. Optimal blocking screw placement for retrograde IM nail fixation of distal femur fracture: a standardized biomechanical study of "osteoporotic" synthetic bone[J].Arch Orthop Trauma Surg,2022,142(12):3827-3835.DOI:10.1007/s00402-021-04280-6.
[27] Aydin M, Surucu S, Ersin M, et al. Determination of the safest level and screw length for the proximal locking screw in retrograde femoral nailing[J].Jt Dis Relat Surg,2023,34(1):69-74.DOI:10.52312/jdrs.2023.949.
[28] Meccariello L, Bisaccia M, Ronga M, et al. Locking retrograde nail, non-locking retrograde nail and plate fixation in the treatment of distal third femoral shaft fractures: radiographic, bone densitometry and clinical outcomes[J].J Orthop Traumatol,2021,22(1):33.DOI:10.1186/s10195-021-00593-9.
[29] 黄新,许平. 逆行带锁髓内钉治疗股骨中下段骨折[J]. 中国实用医药,2009,4(12):95-96.DOI:10.3969/j.issn.1673- 7555.2009.12.057.
[30] Singh SK, El-Gendy KA, Chikkamuniyappa C, et al. The retrograde nail for distal femoral fractures in the elderly: high failure rate of the condyle screw and nut[J].Injury,2006,37(10):1004-1010.DOI:10.1016/j.injury.2006. 01.005.
[31] Davidson A, Houri SS, Cohen J, et al. Initial definitive treatment of open femoral shaft fractures with retrograde nailing - is it safe? A retrospective analysis comparing antegrade to retrograde nailing[J].Injury,2022,53(3):1231-1236.DOI:10.1016/j.injury.2021.09.030.

髓内钉治疗股骨中下段骨折的并发症分析

Complications of intramedullary nailing in the treatment of infra-isthmal femoral fracture

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