闭合复位交锁髓内钉固定结合阻挡钉治疗下肢长骨干骺端骨折

Treatment of metaphyseal fracture of low limb long bone with interlocking intramedullary nails and blocking screws after closed reduction

目的探讨闭合复位应用阻挡钉纠正交锁髓内钉治疗下肢长骨干骺端骨折的疗效。方法回顾性分析手术治疗下肢长骨骨折36例资料。其中,股骨远端骨折15例,胫骨中上1/3骨折5例,胫骨中下1/3骨折16例。均采用闭合复位。术中透视发现骨折端成角畸形,根据骨折端成角的方向以及髓内钉在髓腔内的偏移方向,用阻挡钉辅助纠正骨折端成角畸形和维持骨折端的稳定。结果 36例获随访6-20个月,Karlstrom-Olerud临床评分:优,24例;良,10例;可,2例。结论闭合复位交锁髓内钉结合阻挡钉技术治疗下肢长骨干骺端骨折,可以有效矫正成角畸形,增加骨钉复合体的稳定性。

Objective To evaluate the efficacy of treating metaphyseal fracture of low limb long bone with interlocking intramedullary nails and blocking screws after close reduction.Methods Data of 36 cases underwent close reduction for metaphyseal fracture of low limb long bone were retrospectively analyzed,of whom 15 cases had distal femoral factures,5 proximal one third tibial fractures,16 distal one third tibial fractures.According to the angular deformity and migration of the nail in the intramedullary on X-ray,blocking screws were used to correct and keep the stability of fracture.Results All patients were followed up for 6 to 20 months.Karlstrom-Olerud score concluded as excellent in 24 cases,good in 10 cases,fair in 2 cases.Conclusion Treating metaphyseal fracture of low limb long bone with interlocking intramedullary nails and blocking screws after close reduction can effectively correct the angular deformity and augment the stability of fracture.