【摘要】目的:探讨股骨粗隆部周围骨折周围骨折伽马钉内定内固定术在基层医院无C臂如何开展。方法:治疗52例Russell-Taylor分型IIB、30例IIA。Garden分型III、IV50采用暴露股骨颈前面用直径1mm克氏针于颈前下缘处沿所选伽马钉颈干角大小紧贴颈前面轻轻锤入头内约1cm。再在术前测定的股骨头颈锁钉远侧锁钉在股骨颈的位置以沿颈前面的位置平行第一枚导针轻轻锤入股骨头内1cm确定颈干角,拔掉第一枚导针。确定了锁钉的角度及位置。在大转子顶端前1/3后2/3外略靠近梨状窝边缘,沿股骨解剖轴方向钻入3cm深的克氏针.作为髓腔挫扩髓时的指示针。结果:132 例患者伽马钉内固定满意。结论:股骨头颈内的锁钉远端一颗沿股骨距钻入,固定牢靠,主钉位于股骨髓腔中央,无医源性骨折,克服了扩髓导针引导、C臂定位。操作简单、实用、可靠。是基层实用伽马钉固定股骨粗隆骨折的理想方法。

    【关键词】股骨粗隆周围部骨折;克氏针;前倾角;锁钉位置;主钉位置;移动X光机

    Basic unit thighbone thick prosperous periphery bone fracture gamma nail fixed improvement method

    Zhang Jiaming

    【Abstract】Objective: How discusses around the thighbone thick prosperous periphery bone fracture the bone fracture gamma nail decided but not yet announced in pexia to develop in the basic unit hospital non-C arm. Methods: Treats 52 example Russell-Taylor minute IIB, 30 example IIA. In Garden minute III, IV50 uses in front of the exposed thighbone neck needle the lower limb place along to choose the gamma nail neck with diameter 1mm the Cleveland before the neck to do the angle size to cling in front of the neck the hammer to begin study approximately 1cm gently. The thighbone neck which determines before the technique locks the nail distalis to lock the nail again in the thighbone neck position by along the neck in front of position parallel first guide stem hammer to buy stock in the bone the 1cm determination neck to do the angle gently, captures the first guide stem. Had determined locks nail’s angle and the position. First 1/3 latter outside 2/3 slightly approaches the pear shape nest edge in the big rotor peak, drills into 3cm along the thighbone dissection axis direction the deep Cleveland needle. Frustrates as the medulla cavity expands time marrow’s indicator. Results: in 132 example patient gamma nail fixed satisfaction. Conclusion: In thighbone neck’s lock nail far-end drills into along the thighbone distance, fixed sturdy, main nail located at thighbone medulla cavity central committee, the non-medical source bone fracture, overcame expanded the marrow guide stem guidance, the C arm localization. The simplicity of operator, is practical, is reliable. Is the basic unit practical gamma nail fixed thighbone thick prosperous bone fracture ideal method. ......