带锁髓内钉治疗长骨骨折168例体会

Treatment of 168 patients of long bone fracture with interlocking intramedullary nailing

目的:评价带锁髓内钉治疗股骨、胫骨和肱骨骨折的治疗效果。方法:回顾性分析应用带锁髓内钉治疗长骨骨折168例。其中新鲜骨折144例(闭合性132例,开放性12例),陈旧骨折24例。手术利用"C"型臂行闭合复位或切开复位内固定。陈旧性骨折和骨折粉碎严重的病例行断端植骨,取自体髂骨植骨或自体髂骨加固混合植骨的疗效。结果:平均随访时间29.6个月(9～38个月),愈合166例,愈合率为98.8%,骨折平均愈合时间4.6个月。其中161例(95.8%)一期愈合,5例(3%)二期愈合。延迟愈合5例(3%)。骨折不愈合2例(1.2%);内固定失败5例(3%);感染2例;外伤性骨折2例。结论:应用带锁髓内钉治疗股骨、胫骨和肱骨骨折愈合率高,并发症发生率低,是治疗长骨骨折的一种较为理想的内固定方法。

Objective ： To evaluate the clinical results of femoral tibial and humeral fractures treated with locked intramedullary nailing. Methods： 168 patients with long bone fractures treated with the interlocking nailing were reviewed retrospectively, there were 144 patients of fresh fractures （ 132 close fractures and 12 open fractures）, and 24 ones of old fractures. With image intensifier, both closed reduction and open reduction methods were used in the operation . Bone grafts of the broken ends of fractured bone were used in the old fracture and thrypsis. Results： The patients were followed up with an average of 29.6 months （9-38months）. Among the 168 patients , 166 patients （98.8%） were eventurally healed, with an average union time of 4. 6 months, 161 patients（95. 8%） primarily healed, and 5 patients （3%） healed after secondary operation. The complications were 5 delayed unions （3%）. 2 nounions （1.2%）;Internal fixation failed in 5 patients （3%）, 2 patients were infected , 2 patients had another fractures after operation . Conclusion ： Locked intramedullary nailing is one of the good methods of treating long bone fractures and it has a high union rate and a low complication rate.