胫骨干骨折髓内钉固定后趾屈肌挛缩的预防

Prevent the Contraction of the Flexion Muscles after Intramedullary Fixation of Tibial Shaft Fracture

目的探讨胫骨干骨折髓内钉固定后趾屈肌挛缩原因及预防对策。方法回顾我科2008年9月至2013年9月135例胫骨干骨折行闭合复位髓内钉固定,对术后出现屈肌挛缩的患者临床资料进行分析。结果所有病例均接受随访10~25个月,平均随访17.2个月,其中出现屈趾肌挛缩6例,Ⅰ度挛缩4例,Ⅱ度挛缩2例。结论严格把握手术时机、注意术中操作、术后严密观察对预防小腿后深筋膜室骨筋膜室综合征致趾屈肌挛缩的发生有重大意义,减少伤残率。

Objective To discuss the causes and preventive measures of flexor contracture after intramedullary fixation of tibial shaft fracture. Methods Review patients of tibial shaft fracture underwent fixation with closed reduction and intramedullary nail between September 2008 to September 2013. In total, 135 cases were included.Analyzed the clinical data of patients with flexor contracture after operation. Results All the cases were followed up 10 to 25 months（the average follow-up was 17.2 months）, in which, 6 cases appeared flexor muscle contracture, 4 cases with grade I contracture and 2 cases with grade II. Conclusion Strictly grasp the operation time, note surgery operation and postoperation close observation are important in the prevention of the deep fascia compartment syndrome which cause the flexor contracture, decrease the disability rate.