扩髓交锁钉治疗长骨骨折愈合的临床研究

Clinical study on the treatment of long bone shaft fracture using reamed intramedullary nails(IMN)

目的 :分析扩髓交锁钉对长骨骨折愈合的影响与并发症。方法 :2 3 2例长骨骨折进行交锁钉内固定 ,15 2例扩髓病例获得随访。随访时间 0 .5～ 3 .5年 ,平均 2年 1个月。结果 :骨折愈合时间 8～ 2 8.9周 ,平均 14 .7周。感染 3例 ,延迟愈合 3例。远端锁钉断钉 3例 ,均占 1.97%。本组骨折愈合过程的骨痂从骨外膜处最先出现 ,再形成骨桥 ,完成骨的连接。无脂肪栓塞或急性呼吸窘迫综合征、骨筋膜室综合征发生 ,无不愈合。结论 :扩髓对髓腔内的血供破坏并不影响骨折的愈合 ,扩髓交锁钉具有骨折愈合快、并发症少。

Objective: To analyze complication and influence with fracture union of the treatment of long bone shaft fractures using reamed intramedullary nails. Method: Two hundred and thirty two cases of long bone shaft fractures were treated with intramedullary nails,152 using reamed IMN cases were followed up for 0.5～3.5 years (averaged 2 years and 1 month). Result: One hundred and fifty two cases union time were 8～28.9 weeks, averaged 14.7 weeks. There were 3 cases infection, 1.97%. Three cases of delayed union. Three distant broken screws were found in the group. The primary appearance of bony callus in the periosteum in the course of fracture union. Next it fully grew into bone bridge, until to be united. There was no compartment syndrome, fracture nonunion, fat embolism syndrome (FES) or acute respiratory distress syndrome (ARDS). Conclusion: Reamed intramedullary nail does not disturb the course of fracture union. Using reamed IMN can attain more rapid healing, less complications and firm fixation.