大腿骨複合骨折の治療経験

抄録

The combined femoral fracture according to the Aoyagi definition is a rather rare type of fracture defined as occurring in two or more parts simultaneouslyin the cervical, diaphysial, or condylar part of the femur. Its treatment is often very difficult. We reviewed results of six patients with femoral combined fractures in the past eight years.
All six cases were males with average age of 38.7 years old (range, 22-58 years) at the time of injury. Based on the Aoyagi classification, five of the fractures were Gla and the other one was G2b. Among the Gla patients, two patients received a reconstruction nail, two patients had both a Grosse & Kemph nailand a Knowles pin, and a nother had both CHS and AO broad plates. In the G2b patient, we inserted a Grosse & Kemph nail. For two cases of nonunion, we addeda bone graft.
After treatment all six cases successfully achieved complete union. Their function a evaluation at the final examination was as follows; three cases rated excellent, and three good, based on Karlstrom's criteria.
From these outcomes, we conclude that the reconstruction nail is a useful method for internal fixation in treating combined femoral fractures with the method able to be applied to patients with more communited fractures.