有限切开复位结合带锁髓内钉固定治疗复杂性骨干骨折临床分析

Clinic Analysis of Treatment for Complicated Fracture of Shaft Bones by Limited Open Reduction with Interlocking Intramedullary Nails

目的探讨应用有限切开复位结合带锁髓内钉固定治疗复杂性骨干骨折的临床疗效。方法回顾性分析2006年2月至2009年7月应用有限切开复位结合带锁髓内钉固定治疗肱骨、胫骨及股骨复杂性骨折31例。其中男22例,女9例,平均37.6岁。车祸伤18例,高处坠落伤5例,重物压砸伤3例,摔伤5例。肱骨骨折5例,股骨骨折12例,胫骨骨折14例。闭合骨折19例,开放骨折12例,GustiloⅠ型5例,Ⅱ型7例。顺行置入髓内钉29例,逆行置入髓内钉2例。13例取自体髂骨植骨,2例人工骨植骨。结果全部患者顺利康复出院,X线片复查骨折对位对线均良好。随访半年以上27例,骨折全部愈合。结论有限切开复位结合带锁髓内钉固定治疗复杂性骨干骨折能更好地骨折复位,早期患肢功能锻炼,临床疗效满意,是复杂性骨干骨折的一种有效治疗方法。

Objective To analysis the clinic result of the treatment for complicated fracture of shaft bones by Limited open reduction with interlocking intramedullary nails. Method A retrospective analysis for 31 cases,from the Febrary,2006 to the July,2009,with complicated fracture of shaft bones in femur,tibia and humerus,treated by Limited open reduction with interlocking intramedullary nails. They are 22 males and 9 females and average 37.6 years old. 18 cases caused by traffi c,14 cases in a fall injury,3 cases crushing,5 cases in a fall. By anatomy,5 cases take place in humerus ,12 cases femur,14 cases tibia. 19 cases are closed fracture and 12 open,including 5 cases of Gustilo I and 7 of Gustilo Ⅱ.29 cases with antegrade intramedullary nail placement and 2 retrograde.13 cases implant bone from irrac and 2 artificial bone.Result all the cases are out from hospital after healing and advanced.X-ray examinations show that reduction contain well. 27 cases for a follow-up visit more than half a year and all healing well. Conclusion Limited open reduction with interlocking intramedullary nails can obtain good reduction of fracture,initial functional exercise and satisfi ed clinic result. Which is an effective treatment for complicated fracture of shaft bones.