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观察髓内扩张自锁钉(IESN)治疗股骨干骨折的临床应用规律和疗效.方法 本组股骨干骨折 43例.其中新鲜骨折 38例,含股骨干上 1/3、中下 1/3及下 1/3部位的横形、斜形、螺旋形、多段及粉碎Ⅰ、Ⅱ、Ⅲ、Ⅳ型骨折.陈旧骨折5例,含2例上1/3、3例中下1/3部位骨折;其中1例为斜形,4例为横形骨折,均为其他内固定装置疲劳断裂后形成骨不连.全部病例均采用开放置入髓内钉固定治疗,陈旧性骨折病例植自体骨.结果 经7~25个月(平均13.4个月)的随访,骨折全部愈合.按KLEMM功能恢复分级标准,总体优良率为97.7％.结论(1)IESN及配套器械设计合理,手术操作简便,术中不需X线机监视,易于推广.(2)IESN正确应用,其抗骨折部位弯曲、扭转及短缩能力可靠,可早期功能锻炼,抗疲劳强度好.(3)大部分病例不需扩髓,对局部血运破坏小,有利于骨折愈合.(4)扩大了髓内固定治疗股骨干骨折的适应证.“,”Objective To investigate the curative effects of intramedullary expanded self-locking nail (IESN) in the treatment of femoral shaft fractures. Methods Forty-three cases of femoral shall fractures were treated with open nailing procedure. Of these 43 cases, 38 fractures were fresh in the upper third, me dian third and lower thick of the femoral shaft. The remaining 5 were old fractures, of which 2 were in the upper, 3 in median and lower third (1 oblique fracture, 4 transverse following the failure of internal fixation). Results After 7 to 25 months (average 13. 4 months) follow-up all of the fractures had union and the overall excellent rate was 97. 7% according to Klemm grading. Conclusion IESN is well designed, easy to operate and X - ray monitoring is not neccessary during the procedure. The correct usage of IESN has the advantages of resisting curvature, torture and shortening of fracture. The minimum impairment to local circulation help to Promote the healing.