关键词: 股骨骨折, 旋转预防, 髓内钉, 前倾角, C 形臂

Abstract: Objective To evaluate the feasibility and effectiveness of adjusting mal?rotation based on measurement of femoral neck anteversion using C?arm in intramedullary nail fixation for femoral proximal and middle fractures. Methods A total of 46 patients with femoral proximal and middle fractures were treated with closed reduction and intramedullary nail fixation from June 2015 to June 2017. Twenty?five cases of experimental group were developed according to Brunner method （rotation of femur adjusted based on femoral neck anteversion measurement using C-arm）, and conventional methods are adminis-tered in 21 cases of control group for rotation control. All cases were unilateral closed fractures. Bilateral femur CT scan was performed before operation, and femoral neck anteversion of the normal side was measured, which was used to adjust the proximal rotation in the standard position of distal femur in experimental group. CT scan was performed post?operation in all cases and the femoral neck anteversion of affected side was measured. Results All cases were successfully completed. There was no significant difference in operative time, bleeding volume and fracture healing time between the two groups. The absolute difference of femoral neck anteversion between the normal sand affected side was significantly different（experimental group 4.62°±2.35° vs control group 7.28°±2.93°, P<0.001）. Following up 6 to 24 months with an average of 16.8 months, no bone nonunion, screw cut and other complications were recorded. The St.Michael hip score of 6 months post?operation was statistically significant（experimental group 22.2+1.8 vs control group 20.6±2.0, P=0.01）. Conclusion Measurement of femoral neck antever-sion based on C?arm in intramedullary nail for femoral proximal and middle fractures improves the reduc-tion effect during operation, and significantly reduces the incidence of rotational mal?alignment.

Key words: femoral fracture, rotation prevention, C?arm, anteversion, intramedullary nail