髓内持骨动力性髓内钉治疗四肢长骨中段骨折19例近期疗效分析

Analysis on the short-term efficacy of intramedullary controlled dynamic nailing in the treatment of 19 cases with midshaft fractures

目的探讨髓内持骨动力性髓内钉治疗股骨、胫骨和肱骨中段骨折的近期疗效。方法回顾分析2008-08～2009-08应用髓内持骨动力性髓内钉治疗四肢长骨中段骨折患者的临床资料。术中应用"C"臂机闭合复位,对闭合复位失败者采用有限切开复位内固定,骨折端粉碎严重者行断端自体或混合植骨。结果所有病例均获随访3～14个月,平均8.5个月,19例骨折18例治愈,治愈率为94.7%;骨折平均愈合时间为(16.5±4.2)周;1例发生膝关节僵硬;无发生主钉、锁钉断裂及退出。结论应用髓内持骨动力性髓内钉治疗股骨、胫骨和肱骨中段骨折近期疗效满意,治愈率高,是治疗四肢长骨中段骨折内固定理想方法的选择之一。

Objective To explore the short-term efficacy of intramedullary controlled dynamic nailing in the treatment of midshaft femoral,tibial and humeral fractures. Methods The clinical records of patients with midshaft fractures treated with intramedullary controlled dynamic nailing from August 52008 to August 2009 were retrospectively analyzed. During operation, closed reduction was applied under C arm X ray machine. Finite open reduction and internal fixation was used in patients who failed in closed reduction. Autologous bone grafts or combined bone grafts was used in grave comminuted fracture. Results All the patients were followed up from 3 months to 14 months, with an average of 8. 5 months. Of 19 cases, 18 cases were cured, the cure rate was 94. 7%. the mean healing time was （16. 5 ± 4.2） weeks. Knee stiffness occurred in one patient, no breakage and exiting of nails and locked nails occurred. Conclusion It can get satisfactory short-term efficacy and high cure rate in treatment of midshaft femoral , tibial and humeral fractures by intramedullary controlled dynamic nailing. It is one of the good techniques in treating midshaft fractures.