交锁髓内钉治疗下肢长骨干骨折疗效分析

Therapeutic effect of inter-locking intramedullary nail on long bone diaphysis fractures in lower limbs

目的正确掌握和运用交锁髓内钉内固定技术，对下肢长骨干骨折进行治疗，减少术后并发症，恢复肢体功能。方法对100例下肢长骨干骨折的患者施行交锁髓内钉手术治疗，除2例为股骨干延迟愈合外，其余均为股骨干或胫腓骨新鲜不稳定性骨折。采用国产带瞄准器的交锁髓内钉。6例横断性骨折为闭合复位，其余均为切开复位。结果术后摄X线片显示骨折均为解剖对位，骨折端无成角畸形或碎骨块游离。未出现脂肪栓塞综合征和骨筋膜室综合征，无全身感染情况。除1例股骨干骨折延迟愈合外，其余未出现延迟愈合现象，患肢膝关节屈曲功能恢复至90°～135°。结论交锁髓内钉治疗下肢长骨干骨折，使骨折的固定更加牢靠。提高了患者伤后的生活质量。

Objective To master and use inter-locking intramedullary nail internal fixation technique correctly to treat long bone diaphysis fractures in lower limbs, in order to reduce complications and to recover limb function more effectively, Methods 100 patients with long bone diaphysis fractures in lower limbs were operated with inter-locking intramedullary nails. There were 98 cases of femoral shaft or both tibia and fibula fresh unstable fractures and 2 cases of femoral shaft fractures with delayed union. All patients were treated with incision replacement operation except for 6 cases of traverse fractures. Results All the fractures were completely replacement without deformity and small bone blocks showed by X-ray. All the fractures had bony unions except for one case with delayed union. No acute or deep infections and no complications such as fat embolism or osteofascial compartment syndrome were found after the operation. The function of knee joint recovered well. Conclusion The inter-locking intramedullary nail has replaced some tradition fixing materials with widespread application. It is very ideal to treat diaphysis fracturein lower limbs with inter-locking intramedullary mail, with advantages such as microinvasive injury, few complications, shorter recovery course and higher cure rate. It can recover the function of lower limbs andenhance patient＇ s quality of life.