髓内钉治疗胫骨干骨折的问题分析与处理

Complication and prevention during the treatmentof tibial fracture with interlocking nail

目的:分析带锁髓内钉的治疗效果,减少术中术后的并发症。方法:作者自2000年10月￣2004年10月共随访176位患者,用带锁髓内钉治疗的179例胫骨干骨折。男性138例,女性41例,左侧95例,右侧84例,平均年龄41岁(19￣75岁),随访8￣17个月。结果:术中出现骨折端的劈裂5例;大隐静脉损伤9例。术后出现膝部疼痛16例,主钉折断1例,锁钉退出折断6例,术后感染7例,骨折延迟愈合16例。结论:髓内钉是治疗胫骨干骨折较好的治疗方法,分析产生合并症的原因后采取各种防治措施可明显降低并发症的发生率。

Objective： To analyze the clinical result of intramedullary nail and reduce the postoperative complications. Methods： 179 cases of tibial fracture were treated with intramedullary nail and 176 patients were followed up from October 2000 to October 2004. There were 138 males and 41 females.95 fractures were of left tibial and 84 of right . The mean age was 41 years （rang from 19-75 years ）. Resuits： During the operation ,a split happened to the spot of fracture in 5 cases and great saphenous vein was injured in 9 cases. The complications of postoperation included ： knee pain （sixteen cases）; 1 had nail breakage ,6 had screw loose or breakage, 7 had early infection,16 had delayed union. Conclusion： Using intramedullary nail is a perfect treatment to tibial fracture ,analyse the cause of complication and perform effective measures can reduce the incidence of complications.