AO解剖型胫骨髓内钉微创治疗胫骨远端骨折

AO expert tibial intramedullary nailing for minimally invasive treatment of distal metaphyseal tibial fractures

目的初步探讨国际内固定研究学会（AO）新型解剖型胫骨交锁髓内钉（ETN）微创治疗胫骨远端干骺端骨折的临床疗效。方法对我院2007年11月~2009年11月ETN在透视下闭合复位微创内固定治疗18例距关节面50mm以内的胫骨远端干骺端骨折临床资料进行回顾性分析。结果本组随访时间5~22个月,平均12个月。骨折愈合时间平均为4.5个月（3~6个月）,无感染、无断钉、无畸形愈合和骨不连等并发症。最终结果评分采用Johner-W ruhs评分标准,结果：优17例,良1例;优良率100%。结论 ETN治疗胫骨远端干骺端骨折具有设计合理、操作简单、固定可靠、手术创伤小、并发症少等优点,是治疗胫骨远端干骺端骨折的一种安全、有效的方法。

Objective To discuss the curative effect of AO expert tibial intramedullary nailing（ETN）for minimally invasive treatment of distal metaphyseal tibial fractures.Methods Totally 18 cases of distal tibial fractures located within 50mm of the ankle joint,who were admitted from Nov.2007 to Nov.2009,were retrospectively analyzed.All cases were used ETN to apply minimally invasive fixation under fluoroscopy.Results All patients had been followed-up for 5-22 months,averaging 12 months.All patients were united within an average of 4.5 months（range,3 to 12 months）.According to the Johner-Wruhs criteria： excellent in 17 cases,good in 1 case.Complications such as infection,nail breakage,malunion and bone nonunion were not observed.Conclusion ETN has advantages of reasonable design,simple operation,stable fixation,minimally invasive trauma,fewer complications.It is a safe and effective method for the treatment of distal metaphyseal tibial fractures.