交锁髓内钉治疗胫骨骨折的并发症分析及对策

Cause Analysis and Handling of the Postoperative Complications of Fracture of tibia Treated with intramedullary Interlocking Nails

目的分析交锁髓内钉治疗胫骨骨折并发症原因,提出防治措施。方法我院2002年1月～2009年1月对218例胫骨骨折行交锁髓内钉内固定手术治疗,随访186例,发生骨延迟愈合、锁钉断裂、主钉折弯合并小腿成角畸形等并发症共16例。我们采用①改静力交锁为动力交锁;②骨愈合刺激仪促进骨折愈合;③经皮自体骨髓间充质干细胞移植治疗。结果胫骨骨折均骨愈合,无骨不连,无感染,无畸形愈合。结论交锁髓内钉是治疗胫腓骨骨折的有效手段,严格掌握手术指征、适时掌握静力与动力固定是减少并发症的有效措施。

objective To study the causes and prevention as well as treatment methods of the postoperative complications of fracture of tibia treated with Intramedullary Interlocking Nails . Method 218 fracture of tibia from January 2002 to January 2009 in our hospital were treated with Intramedullary Interlocking Nails,186 were followed up, There were 16 fractures having complications,including delayed union,interlocking nail breakage,main nails folding and shank angulation deformed.we applied them include conversion of the fixation from static to dynamic and Pulsed Electromagnetic Fields （PEMFs）and Transplantation of percutaneous autologous mesenchymal stem cells for treatment. Result all Fractures of tibia were bone healing,without nonunion,free from infection,no malunion. Conclusion The Intramedullary Interlocking Nailing is a effective measure of treating the fracture of tibia, The efffective measure is to reduce them include strict operative indications,conversion of the fixation from static to dynamic in time.