梅花型髓内钉固定股骨中、上段骨折，传统采用逆行打针法，常产生股骨大粗隆暴裂骨折。近年来，有作者改用导针引导顺行打钉，避免了这一缺点。但是，由于所制导针细小，容易弯曲，穿出股骨大粗隆困难，导致引导失败。为此，自1993年以来，我们对其进行了改进，并用于临床，取 Plum-type intramedullary nails fix the fractures of the middle and upper parts of the femur. Traditionally, retrograde injections are used, often resulting in fracture fractures of the femoral great trochanter. In recent years, some authors have used guide pins to guide antegrade nailing to avoid this shortcoming. However, due to the small size of the guide pin, it is easy to bend, and it is difficult to pierce the large trochanter of the femur, leading to failure of the guide. To this end, since 1993, we have improved it and used it in clinical practice.