交锁髓内钉治疗胫骨骨折36例

Treatment of Tibial Shaft Fractures with Inter-locking Intramedullary Nail

目的:探讨交锁髓内钉治疗胫骨骨折的应用、手术方式选择及疗效。方法:对使用交锁髓内钉治疗36例胫骨骨折的疗效进行回顾性分析。手术采用闭合、小切口或有限切开复位,用三维瞄准器锁定骨折远、近端。结果36例患者平均随访14个月。肢体、关节功能恢复优良率为86.1%;一期骨折愈合率为89.6%。平均临床愈合时间为6.8个月。结论:交锁骨髓内钉是目前治疗胫骨骨折的首选方法,术中应常规静力固定,不剥离或少剥离骨膜,不强求解剖复位,尽量闭合复位,有限扩髓。

Objective：To explore the optimal operation manners of interlocking intramedullary nail in treating tibial shaft fractures and its therapeutic effects. Methods： thirty-six cases of femoral shaft fractures treated with inter-locking intrfracture were locked with nails by a tris-dimension aim implement. Results.. All cases were followed up for averaged 14 months. There was 86. 1 of all cases that showed excellent function of joints and limbs, and 89.6 of showed union of fracture（averaged 6. 8 months）. Conclusion： Inter-locking intramedullary nail is the first choice in treating tibial shaft fractures. Static locking should be a routine way , and closed reduction, limited enlarging marrows cavity and no or minimal stripping periosteum should be emphasized in the operation of femoral shaft fractures.