Application of Homemade Steel Wire Introducer in Intramedullary Nailing of Subtrochanteric Fracture of Femur
Objective: To investigate the application value of self-made wire introducer in intramedullary nail op-eration of subtrochanteric fracture of femur. Methods: From January 2019 to December 2021, the clinical data of 54 patients with subtrochanteric fracture who needed binding and assisted reduction were retrospectively analyzed. There were 28 males and 26 females. The age ranged from 22 to 81years[(55.78±12.25)years]. According to Seinsheimer classification, there were 11 cases of ⅢA, 12 cases of ⅢB, 21 cases of IVI, and 10 cases of VI. The injury factors in-cluded careless fall injury in 15 cases, heavy object injury in 7 cases, traffic injury in 22 cases, and falling injury in 10 cases. The time from injury to operation was 2～7 days [(3.53±1.28) days]. The size of the auxiliary incision, completion time of strapping, operation time, intraoperative blood loss, fracture reduction and postoperative complications were observed. The Harris score of hip joint function was performed at 9months after operation. Results: The median inci-sion was 2.8cm (range 2.5～3.2 cm). The completion time of binding import was 5～8 min, with a median of 6.5min. The median operation time was 72min (range 56-90min). The intraoperative blood loss was 120～280 ml, with a median of 180ml. All patients had no early complications such as incision infection and neurovascular injury. The follow-up time was 9～24months, with a median of 12months. Satisfactory reduction results were obtained in all cases. 52 cases healing as scheduled, the clinical healing time was 11～24weeks, with a median of 15weeks; Delayed fracture healing occurred in 2 cases, and the affected limb was treated with extended weight-bearing time, combined with dynamic and shock wave therapy, and the fracture healed 10months after operation. No late complications such as bone infection, nonunion and internal fixation failure were found. The Harris score of hip joint function at 9months after operation was excellent in 46 cases, good in 6 cases, and fair in 2 cases. The excellent and good rate was 96.3％. Conclusion: The application of self-made wire guide for binding and fixation in intramedullary nail fixation of subtrochanteric fracture requiring bind-ing and reduction has the advantages of simple operation, small auxiliary incision, less bleeding, high success rate of binding, fast, efficient, safe and minimally invasive, which is worthy of clinical reference application.
Subtrochanteric fracture of femurIntramedullary nailWire cerclage
万方数据
维普
