以Ender氏骨釘治療骰骨轉子間骨折之臨床經驗

Clinical Experience in Ender Nailing of Intertrochanteric Fractures of the Femur

王德源(Der-Yean Wang) ； 林茂仁(Mou-Jen Lin) ； 何火煉(Huo-Lien Ho)

《Journal of Orthopaedic Surgery Taiwan》 7卷2期 (1990/06) Pp. 124-131

摘要

從1982年7月至1986年12月止，於中國醫藥學院附設醫院總共有77例股骨轉子間骨折之病接受Ender氏骨釘內固定治療。年齡從20歲到104歲，平均為69.7歲。男性有36位，女性有41位其中有一例因麻醉併發症故未及開刀即死亡，有二例因它病而在開刀後未滿四星期內死亡，其餘74例追蹤時間至少六個月以上，其骨折處均癒合良好，平均手術時間為54.6分，平均出血量為150cc，有二例發生淺部傷口感染，有12例在打入骨釘之骨洞處發生縱走之裂痕，有六例骨釘滑脫，有二例骨釘穿透股骨頭，有16例膝部不舒服，有六例膝部活動度受限，有六例發生超過20度之外翻變形。我們的經驗發對於穩定型之股骨轉子間骨折，使用Ender氏骨內釘固定,其結果相當令人滿意，但對於不穩定型之病例，則須由較有經驗之醫師來執行手術，才可能得到較好之結果。對於身為骨科醫師而言，提供另一種可選擇的治療工具，尤其對老年人之穩定型股骨轉子間骨折，而不適合長期麻醉時，此乃簡單、迅速、出血量少、感染率低的理想手術方法。

並列摘要

From July 1980 to December 1986, 77 intertrochanteric fractures of the femur had been treated by Ender’s nailing at China Medical College Hospital.
The distribution of age was from 20 to 104 years old. There were 36 males and 41 females old. There were 36 males and 41 females. one of them died during anesthesia. Another two died within 4 weeks after surgery. The other 74 cases were followed up for more than 6 months. All of them had obtained fracture union.
Average operation time was 54.5 minutes. Average blood loss was 150 c.c.. There were several complications. These included 2 superficial wound infection, 6 inferior migration of the nail, 2 nail penetration of the head, 16 knee discomfort, 6 limitation of knee joint motion, 6 with an external rotation deformity of more than 20 degrees.
We had found that there were satisfactory results in the cases of stable-type of intertrochanteric fracture of the femur treated by Ender nailing.
But it is technique-demanding while using this method in treating the unstable-type of intertrochanteric fracture of the femur.
Ender nailing for stable-type of intertrochanteric fracture of the femur in elderly people is a simple method with low blood loss and low infection rate. It will certainly by part of armamentarium of the orthopedic surgeon.