带锁髓内钉固定治疗胫骨骨折(附43例报告)

Fructure of the Tibia Treated with a Intramedullury Interlocking Nail

目的 :分析总结带锁髓内钉固定治疗胫骨骨折。方法 :作者回顾了 43例胫骨骨折 ,均采用带锁髓内钉固定治疗 ,其中闭合骨折 32例 ,开放骨折 11例。43例骨折平均随访 15 .6个月 (4～ 40个月 )。疗效评定采用 Johner- wruh评分标准 ,结果 :在 32例闭合骨折中 ,最终结果优 2 8例 ,良 3例 ,中 1例 ;在 11例开放骨折中 ,优 8例 ,良 2例 ,差 1例。以上 43例病人手术后均无继发性骨筋膜室综合征 ,神经损伤、钉体断裂等情况发生 ,结果 :作者认为带锁髓内钉非常适用于闭合的胫骨骨折 ,而在治疗开放骨折时 ,因感染率高 。

Objective:To analyse Fracture of the tibia treated with a intramedullary interlocking nail.Mdthods:Fourty three unstable fractures of the tibia treated with a reamed intramdullary interlocking nail were reviewed. There were 32 closed and 11 open Fractures. Fourty three patients were followed-up for an average of 15.6 months (ranged 4 to 40 months) and evaluated according to the criteria of Johner and Wruh.Results:In the closed fractures.there were 28 assessed as excellent,3 as good and 1 as fair.In the open Fractures,there were 8 assessed as excellent,2 as good and 1 as poor.There were no postoperation compartment syndromes,neurological deficits,broken nails and screws in this series.Conclusion:The authors concluded that the intramedcullary nails is indicated only for the unstable cloled tibial shaft fractures and it should not be recommended for then open fracture because of the lnacceptably high infection rate.