大腿骨分節骨折に対し髄内釘とロッキング・プレートを併用して固定した 1 例

概要

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We report our experience with a 56-year-old female patient who made good progress after fixation of two implants, an intramedullary nail and a locking compression plate (LCP) for a segmental fracture of the femur. She had been struck by a car when riding a motorcycle, and was brought to the hospital by ambulance. She had a segmental fracture (AO classification 32-B2, 33-A3) of the femur combined with fractures of the right calcaneal bone, ankle, lateral malleolus, and foot. Wire traction was applied, and we performed open reduction inter-fixation with an intramedullary nail and a LCP on the distal femur 12 days after injury. We used a cable system and a periprosthetic screw on the LCP for the intermediate part of the bone chip. Synostosis was obtained in four months after surgery, and the patient is making satisfactory progress. An intramedullary nail is considered to be the first choice for fixation of segmental fracture of the femur. However, in the present case, we chose to use a plate together with an intramedullary nail, because the condyle part of the bone chip was small, and we expected that fixation with an intramedullary nail would be inadequate. A LCP, cable system and periprosthetic screw were useful for fixation to the bone chip bearing an inserted intramedullary nail.
中国・四国整形外科学会の論文