具有限深套管的股骨带锁髓内钉尾端扩孔器的设计与临床应用

目的改良设计股骨带锁髓内钉钉尾扩孔器，降低股骨髓内钉内固定手术难度，缩短手术时间，减少医源性损伤。方法本课题组于2007年逐步改进股骨带锁髓内钉钉尾扩孔器的设计，于2008年申请并获得国家实用新型专利。2007年7月至2008年12月间用于治疗股骨干骨折21例，平均随访16个月。结果术中应用获得专利的带有限深套管的髓内钉钉尾扩孔器，所有21例手术都顺利完成，手术时间缩短至45～55min，平均为48min。随访5～22个月，平均随访16个月。术后患者均达到临床愈合，骨折愈合时间最短4个月，最长7个月，平均6个月。无一例在术中及随访期间发生因钉尾扩孔不理想及髓内钉位置偏移而导致的术中医源性骨折、髓内钉钉插入困难、术后股骨颈骨折、股骨头坏死等并发症。结论通过新型股骨带锁髓内钉钉尾扩孔器装置的改良可以提高手术效率，使手术操作简便，缩短手术时间，减少并发症。

Design and Clinical Application of Hole Reamer with Depth Restrictor for Interlocking Intramedullary Nail in Treatment of Femoral Fractures

Objective To improve the design of hole reamer for interlocking intramedullary nail of femoral fractures,shorten operation time, decrease operation difficulty and surgical injury. Methods The new hole reamer for interlocking intramedullary nail was designed in 2007. This equipment obtained a China National practical new-type patent in 2008. The new hole reamer was used in 21 cases of femoral fractures treated with locking intramedullary nail fixation from July 2007 to December 2008. The patients were followed up for an average of 16 months. Results With the use of this new patent hole reamer with depth restrietor for interlocking intramedullary nail, the 21 operations had completed successfully. The operative duration was 45～55 minutes, averaged 48 minutes. All the patients were followed up for 5～22 months, averaged 16 months. All of the cases achieved clinical healing after sur-gery, The bone healing time averaged 6 months (4 to 7 months). No complications occurred, such as iatrogenic fracture in operation, locking disabilities, postoperative femoral neck fracture. Conclusions The improvement of technology and equipment can increase efficiency, shorten operation time, decrease operation difficulty and surgical injury. This hole re-amer for interlocking intramedullary nail is more suitable for field environment, emergency rescue, disaster relief and pri-mary hospital.