１５歳〜２０歳における大腿骨骨幹部骨折に対する髄内釘の治療経験

Abstract

It is sometimes difficult to choose the fixator of femoral shaft fractures in patients between the ages of 15 and 20, because of a remaining epiphyseal line or medullary space narrowing. We report a study on the surgical treatment of femoral shaft fractures with intramedullary nail in this age range. Forty-one femoral shaft fractures treated by intramedullary nail, which could be surveyed for over 3 months out of the 46 femoral shaft fractures we experienced for 10 years (from 1992 to 2002), were studied. Thirty-four patients were male and 7 female, with the mean age at surgery of 17.8 years. Thirteen patients were 1/3 proximal fracture, 24 were 1/3 middle fractures, and 4 were 1/3 distal fractures. Twenty-five fractures were type A, 11 were type B, and 5 were type C separated by AO’s classification. Thirty-four fractures were operated with Russell-Taylor nails (2 were reconstruction nails), and 5 were with Ender nails. Follow-up periods ranged from 3 months to 34.5 months (average: 17.5 months). We researched their range of motion, the period until bone union, and so on, separating AO’s classification, and their fixator. The average period of bone union was 23.9 weeks, and all patients were cured by bone union. Four patients underwent dynamization.