闭合复位有限扩髓带锁髓内钉治疗胫骨骨折

Closed reduction and limited reamed interlocking nailing for the treatment of tibial fractures

目的探讨闭合复位、有限扩髓带锁髓内钉治疗胫骨骨折的疗效。方法应用闭合复位、有限扩髓带锁髓内钉治疗胫骨骨折73例,均静力固定。对合并有腓骨骨折的胫骨不稳定性骨折,行腓骨骨折固定。结果患者均获随访,时间6～21(13.6±3.2)个月,骨折均愈合,时间4～10(6.2±1.6)个月。功能恢复按Johner-Wruhs标准:优62例,良11例。3例出现骨折延迟愈合,无骨折畸形愈合、小腿骨筋膜室综合征、断钉等并发症。结论闭合复位、有限扩髓带锁髓内钉治疗胫骨骨折具有固定牢固、微创、加快骨折愈合,减少骨不连、断钉等优势,是治疗胫骨骨折一种较好的内固定方法。

Objective To study the clinical effect of the treatment of the tibial fractures using interlocking intramedullary nail with closed reduction and limited reaming. Methods 73 cases of tibial fractures were treated with closed reduction and static limited reamed intramedullary nailing. There fibula fractures associated with unstable tibial fractures were fixed. Results All cases were followed up for 6 - 21 （ 13.6± 3.2 ） months. All fractures patients healed in 4 - 10 （6. 2 ± 1.6） months. According to the functional recovery Johner-Wruhs standard, the results were excellent in 62 cases, good in 11.3 cases got delayed union. No mulunion, compartment syndrome, instrument breakage was found. Conclusions Closed reduction and limited reamed interlocking nailing for the treatment of fractures of the tibia can provide firm fixation and minimally invasion, which speed up fracture healing and reduce nonunion, nails breakage and other advantages. It is a good method to treatment of tibial fractures.