摘要: 目的 评价股骨转子下骨折应用加长型股骨近端髓内钉(PFN)或伽码(gamma)钉内固定的治疗 效果。 方法 49例股骨转子下骨折采用加长型PFN或gamma钉内固定治疗，C臂机透视下牵引复位，必要时 骨折断端小切口切开复位，钢丝环扎或钢缆捆绑。 结果 除1例发生骨折延迟愈合外， 其余48例骨折全部无 障碍愈合。术后半年随访时所有病例功能恢复良好，闭合复位成功32例，小切口钢丝环扎或钢缆捆绑复位固 定17例。手术时间平均46分钟。18例Seinsheimer Ⅱ型骨折未作远端交锁，其余病例全部在远端用1枚螺栓 做静力交锁固定。无螺钉切割移位或内植物断裂等并发症。 结论 股骨转子下骨折采用加长型PFN或gam- ma钉内固定，手术创伤小，骨折愈合率高，符合生物力学要求。其技术要求高，应避免并发症发生。

    关键词: 股骨骨折; 股骨转子; 内固定

    Treatment of subtrochanteric fracture with long PFN or gamma nail JIANG Lei-sheng，WANG Wei，DAI Li-yang (Department of Orthopaedic Surgery，Xinhua Hospital，Shanghai SecondMedical University，Shanghai 200092，China)

    Abstract: Objective To evaluate the clinical outcome of subtrochanteric fractures fixed with long PFN or gamma nail. Methods Forty-nine cases of traumatic subtrochanteric fractures were intramedullary fixed with a long PFN or a long gamma nail. Reduction was performed under traction and C-arm fluoroscopy on a fracture table，with cerclage wiring or cable bandage through a mini incision when necessary. Results All the 49 cases of subtrochan- teric fractures healed uneventfully except 1 case of delayed union. Walking and squatting ability was completely re- stored in each case at follow-up examination of 6 months postoperatively. Among them ......