髓内扩张自锁钉治疗不稳定性胫骨骨折

Treatment of unstable tibial fracture with intramedullary expanding self-locking nail

目的 :探讨髓内扩张自锁钉治疗不稳定性胫骨骨折的临床疗效。方法 :采用髓内扩张自锁钉治疗不稳定性新鲜胫骨骨折 3 9例 ,其中开放性骨折 5例 ,闭合性骨折 3 4例 ;2 4例采用闭合复位顺行打入髓内扩张自锁钉 ,15例采用小切口辅助骨折复位、顺行打入髓内扩张自锁钉。结果 :随访 8～ 48个月 ,平均 2 8个月 ;3 7例骨折解剖复位愈合 ,1例轻度成角 ( <10°) ,1例不愈合。按Johner Wruhs功能恢复分级标准 ,总体优良率为 92 3 %。结论 :髓内扩张自锁钉治疗胫骨骨折 ,具有手术简单、微创、骨折愈合率高的特点 ,是一种较好的内固定方法。

Objective:To explore the therapeutic effect of intramedullary expanding self-locking nail on unstable tibial fracture.Methods:Intramedullary expanding self-locking nail was used to treat 39 cases of fresh unstable tibial fracture with open fracture in 5 cases,the closed in 34 cases.Closed reduction with anterograde nailing was performed in 24 cases;small incision plus reduction of the fracture with anterograde nailing were carried out in 15 patients.Results:All the patients were followed up for the period of 8 to 48 months with a mean time of 28 months.Complete union was found in 37 cases;slight angulation in 1 case (<10°);nonunion in 1 case.The final outcome was evaluated with Johner Wruhs Criteria.And comprehensively,the rate of good and excellent functional recoveries was 92.3%.Conclusions:Intramedullary expanding self-locking nail was satisfactory internal fixation method for fracture of tibia,being characterized by simplicity,micro-invasion and high rate of fracture union.