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Trục xương đùi

Ngược intramedullary đóng đinh xương đùi bị gãy trục của việc sử dụng một xa với nội khớp là cổng thông tin nhập intercondylar Một kỹ thuật phẫu thuật tương đối mới. Phương pháp đóng đinh Đại diện cho một thay đổi Trước đây mô tả của thủ tục trong khớp, thêm năm nào vào cổng thông tin trung gian đùi | Perspectives on Modern Orthopaedics Retrograde Nailing of the Femoral Shaft Berton R. Moed MD and J. Tracy Watson MD Abstract Retrograde intramedullary nailing of fractures of the femoral shaft with use of a distal intercondylar intra-articular entry portal is a relatively new surgical technique. This method of nailing represents a modification of the previously described procedure in which an extra-articular entry portal in the medial femoral condyle was used. The earlier procedure was plagued by technical difficulties which limited its use these problems were mainly related to the fact that the entry portal was not in line with the intramedullary canal as well as to the fact that purpose-specific implants and instrumentation were not available. Modification of this technique by using the intercondylar entry portal and a nail designed for retrograde insertion has proved very effective in clinical studies. There have been theoretical concerns regarding postoperative knee function and intraoperative injury to important anatomic structures such as branches of the femoral nerve however laboratory and clinical findings have dispelled many of these concerns and have provided firm support for continued use of the technique. Nonetheless further study is required to delineate the long-term outcome of knee joint function. Current indications for use of this technique include multisystem injuries multiple fractures including ipsilateral lower-limb combination injuries ipsilateral vascular injuries periprosthetic fractures and morbid obesity. J Am Acad Orthop Surg 1999 7 209-216 ing was shown to be associated with trochanteric pain 40 of patients thigh pain 10 stiffness 38 limp 13 reduced walking distance 12.5 and difficulty with stairs related to hip abductor muscle weakness 10 . In another series 14 limited walking standing or stair-climbing ability was noted in 39 of patients with 37 having some pain or discomfort. The concept of retrograde femoral shaft fracture fixation