交锁髓内钉治疗胫骨不稳定性骨折

Treatment of unstable tibial fracture with interlocking intramedullary nail in 38 cases

目的 探讨交锁髓内钉治疗胫骨不稳定骨折的治疗效果。方法 本研究 3 8例中不扩髓法 3 1例 ,扩髓法 7例 ;闭合穿针3 3例 ,开放穿针 5例 ;静力性固定 3 2例 ,动力性固定 6例。结果 平均随访时间 10月 (3～ 2 2月 ) ,采用Johner Wruh评分标准 ,对治疗的最终结果评定 :优 3 1例 ,良 5例 ,中 1例 ,差 1例。骨折平均愈合时间 :闭合性骨折 16周 (11～ 2 4周 ) ,开放性骨折 18周 (12～ 2 6周 ) ,2例延迟愈合 (闭合性骨折、开放性骨折各 1例 ) ,无感染及骨不连。结论 交锁髓内钉是治疗胫骨不稳定骨折的较好方法之一。

Objective To explore the therapeutic effect of interlocking intramedullary nail for unstable tibial fracture. Methods Among 38 cases of unstable tibial fracture, including 11 open and 27 closed fracture, 31 were treated with reamed interlocking intramedullary nail and 6 with unreamed interlocking intramedullary nail. Thirty three cases were performed with closed nailing and 5 with open nailing, and of 32 was fixed statically and 6 dynamically. Follow up for a mean duration of 10 months (3～22 months) and finally evaluated with Johner&Wruhs, criteria. Results In the assessment, the outcome was excellent in 31 cases, good in 5 cases, fair in 1 case and poor in 1 case. The time for fracture union averaged 16 weeks (11～24 weeks) in closed fracture and 18 weeks (12～26 weeks) in open fracture. Delayed union was found in 1 case of closed fracture and 1 case of open fracture. No infection and nonunion was observed in this study. Conclusion Interlocking intramedullary nail is an ideal internal fixation method to treat unstable tibial fracture.