交锁髓内钉治疗胫骨骨折并发症及防治

Complications and prevention for the treatment of Tibial Fractures with Interlocking Intramedullary Nail

目的分析交锁髓内钉治疗胫骨骨折并发症的原因,并提出防治措施。方法自2002年1月至 2005年6月应用胫骨交锁髓内钉治疗胫骨骨折131例,均采用扩髓及静力性固定。结果本组术后并发症21例,并发症发生率为16．0％,随访1年以上。其中感染3例,延期愈合5例,远段锁钉放置失败5 例,锁钉断钉1例,退钉2例,(?)长伸肌腱损伤1例,内外翻畸形2例,术后膝前痛2例。结论熟练掌握交锁髓内钉操作,严格掌握适应证可以减少并发症,提高疗效。

Objective To analyze the cause for complications of the tibial fractures treated with the interlocking Intramedullary nail and indicate the prevention and treatment measures. Methods From January 2002 to June 2005, 131 patients with the tibial fractures were treated with the interlocking Intramedullary nail. Open or close reduction and static fixation with reamed nails were applied in all patients. Results All patients were followed up for 12 months. Complications occurred in 21 cases including 3 cases of infection, 5 delayed union, 5 distal screw misinserted, deformity 2 cases,1 distal screw broken and 2 distal screws loosening, 1 injury of extensor hallucis longus and anterior knee pain was found in 2 cases postoperatively. Conclusion The effective measures to reduce the complications include strict master of the operative indications and skillful manipulation of the interlocking nail.