【摘要】 目的　探讨并介绍旋入式自锁髓内钉经髁间逆行入路治疗股骨下段骨折的方法及疗效。方法　采用旋入钉逆行固定股骨下 1/3及髁上骨折 38例 ,其中非稳定性骨折 2 4例 ,C3 型骨折 3例 ,合并同侧股骨多节段骨折 5例 ,同侧髌骨骨折 6例和同侧胫骨骨折 4例 ;以闭合复位固定 11例 ,开放复位固定 2 7例 ,其中 16例行钢丝环扎固定 ,2 8例获得 6个月以上随访。结果86 %的骨折达到解剖或接近解剖复位 ,无术后感染 ,骨折平均愈合时间 15周 ,术后 2个月膝关节功能完全恢复率达 82 % ,3个月内膝关节疼痛完全消失率为 78%。结论　旋入钉以股骨中轴线逆行固定 ,无应力遮挡和应力集中 ,骨折愈合快 ,手术操作简便快捷 ,是一种较好的髓内固定方法。更多还原

【Abstract】 Objective To discuss and introduce the method of the RSIN for treatment distal fractures of the femur through intercondylar retrograde approach.Methods Thirty eight cases of supracondylar and lower 1/3 fracture of femur were treated with RSIN through intercondylar retrograde approach. Of them, 24 cases were unstability, 3 cases were type C 3, 5 cases complicated with same side segment fractures, 6 cases complicated with same side patella fracture and 2 cases tibial fracture.Eleven cases were treated in closed reduction, 27 cases were open reduction, 16 of them were bundled with steel wire.Twenty eight cases were followed-up over half a year. Results Percent eighty six of the fractures were anatomic reduction or nearly anatomic reduction without infection and ununion of fractures. 100% union of fractures. Average union time of factures was 15 weeks. The rate of function of knee joint entirely recovered was 82% in two months after operation. Seventy eight case pain of knes disappeared in three months.Conclusion The RSIN passes the femur center axes to fix the fracture, so overcome the stress block and stress concentration. Self-locked operation is easy and prompt, short time of fracture union.It is regarded a good method to pass medullar cavity fixtion.更多还原