骨質疏鬆會增加老年人骨折的機會,它也說明老年人骨折後用鋼釘內固定後容易失敗的原因。本篇論文報告一位78歲女性病患因為同側股骨幹再次骨折接受骨隨內互鎖式內固定釘(interlocking nail)固定和骨頭移植手術治療後,又發生股骨頸底骨折,起初計劃用Knowles氏鋼釘(Knowles pin)或骨鬆層螺釘(cancellous screw)來作內固定。因為骨頭疏鬆都無法達到穩定的固定,所以改用壓迫性髖螺旋釘和鋼板(compression hip screw & plate)來固定,術後恢復良好,一年後骨頭已癒合。
Osteoporosis is the most determinant factor for the increase of fracture risks associated with aging and it accounts for high rates of loss of reduction. This paper presents a case of a 78-year-old woman with femoral basal neck fracture after the admission of interlocking nail and autogenous bone graft for ispilateral femoral shaft refracture. Initially multiple Knowle's pins or cancellous screws were planned but loose purchas over the femoral head was noted. So hip compression screw and plat was chosen. Postoperative course was smooth. Bony union was noted one year later.