有限切开复位交锁髓内钉内固定在胫骨粉碎及多段骨折中的应用

Limited open reduction and interlocking intramedullary nailing for comminuted and segmental tibial fractures

目的 探讨胫骨粉碎性及多段骨折的治疗效果。方法 采用有限切开复位交锁髓内钉固定治疗胫骨粉碎性及多段骨折 4 2例 ,其中车祸伤 2 7例 ,压砸伤 11例 ,高处坠落伤 4例。C1型 31例 ,C2型 6例 ,C3型5例。结果 全部病例获得随访 ,时间 6～ 2 0个月。按Johner Wruh胫骨骨折评分标准 :优 38例 ,良 4例。结论 有限切开复位交锁髓内钉固定治疗胫骨粉碎性及多段骨折 ,在直视下争取一次复位成功 ,大大缩短复位时间 ,提高复位质量 ,基本不加重原创伤 ,对局部血供影响小 ,有利于骨折的修复。

Objective To investigate the effect of limited open reduction and interlocking intramedullary nailing for comminuted and segmental tibial fractures.Methods 42 cases of comminuted and segmental tibial fractures were treated with limited open reduction and interlocking intramedullary nailing,which included 31 cases type C1,6 C2,and 5 C3.Results All cases were followed up for 6～20 months. According to Johner-Wruh tibial fracture scoring system,the results were excellent in 38 cases and good in 4. Conclusion The method provides direct visurlized reduction, which make it possible to get reduction at one set and reduces the reduction time, improves reduction quality without additional trauma or severe intervention of local vascular support, so it is beneficial for fracture healing.