自制胫骨髓内钉空心开口取骨器在胫骨中下段粉碎性骨折中的应用研究

Application research on self-made hollow instrument to get into and obtain bone in the proximal tibial in treating tibial middle and lower fractures undergoing intramedullary nailing fixxing

目的探讨自制胫骨髓内钉空心开口取骨器于开孔处取骨、一期植骨治疗胫骨中下段粉碎性骨折的疗效及优点。方法对36例胫骨中下段粉碎性骨折患者行交锁髓内钉内固定治疗，并用自制胫骨髓内钉空心开口取骨器于开孔处取骨、一期植骨。结果患者均获随访，随访时间8-16个月，骨折愈合时间4-7个月。临床疗效根据Johner栋ruhs评分标准：优31例，良5例。结论采用交锁髓内钉内固定加自制胫骨髓内钉空心开口取骨器于开孔处取骨、植骨治疗胫骨中下段粉碎性骨折，既可避免二期植骨手术和髂骨取骨的并发症．又能充分修复缺损，提高骨折一期愈合率。

Objective To explore the therapeutic effect and advantage of self-made hollow instrument to get into and obtain bone in the proximal tibial and transplace the bone into the place of tibial middle and lower fractures undergoing intramedullary nailing fixing. Methods The clinical data of 36 cases of the tibial middle and lower fractures were analyzed retrospectively. All of the patients were treated to get into and obtain bone in the proximal tibial with the self-made hollow instrument, and transplace the bone into the place of tibial middle and lower fractures undergoing intramedullary nailing fixing. Results All patients were followed up from 8 to 16 months. The tibial middle and lower fractures were healed from 4 to 7 months. According to Johner-Wruhs clinical grading system, 31 cases were excellent, 5 cases were good. Conclu- sion Using self-made hollow instnlment to get into and obtain bone in the proximal tibial, and transplace the bone into the place of tibial middle and lower fractures undergoing intramedullary nailing fixing, has more advantages, including avoiding to obtain bone from ilium and transplance the bone in the two periods, more reliable repaired bone gap and improve the heal rate of the tibial middle and lower fractures. So the self-made hollow instrument to get into and obtain bone in the proximal tibial should be promoted with clinical application.