头髓钉固定股骨转子间骨折内锁螺钉的研究进展

Research progress in inner interlocking screw of cephalomedullary nail for intertrochanteric fractures

摘要:

目前老年股骨转子间骨折的治疗，头髓钉固定已成主流手术方式。除亚洲型股骨近端防旋髓内钉（proximal femoral nail anti-rotation-Ⅱ, PFNA-Ⅱ）外，头髓钉的主钉尾部都含有内锁螺钉。内锁螺钉的初始作用是防止头颈内置物的旋转，术中是否拧牢内锁螺钉，从而阻止或保留头颈内置物的滑动，临床上有不少争议。本文通过查阅文献和各种头髓钉说明书，从内锁螺钉的历史、种类、临床应用及使用争议等方面进行总结分析，以期取得内锁螺钉使用共识，为提高股骨转子间骨折固定疗效提供参考。

Abstract:

Cephalomedullary nail fixation has become a mainstream surgical method for femoral intertrochanteric fractures in the elderly at present. Except for Asian proximal femoral nail anti-rotation-II (PFNA-II), all cephalomedullary nails contain inner locking screws at the tail of the main nail. The initial function of the inner locking screw is to prevent the rotation of the implants in the head and neck. There is a lot of clinical controversy about whether to tighten the inner locking screw during the operation to prevent or preserve the sliding of the implants in the head and neck. By referring to the literature and the instructions of various cephalomedullary nails, this paper summarized and analyzed the history, types, clinical application and use disputes of inner locking screws, so as to obtain a consensus on the use of inner locking screws and provide reference for improving the fixation effect of femoral intertrochanteric fractures.