交锁髓内钉加髂骨植骨治疗胫骨骨缺损的临床应用

Clinical application of interlocking intramedullary nail combined with iliac bone graft for tibial defects

目的探讨交锁髓内钉加髂骨植骨治疗胫骨骨缺损的方法及疗效。方法回顾性分析2009年2月~2013年10月采用交锁髓内钉内固定加髂骨植骨治疗18例因创伤导致的胫骨骨缺损患者资料,男性12例,女性6例;年龄31~67岁,平均42岁。受伤至手术时间2~4个月,平均3个月。术后采用Johner-Wruhs评定标准评估疗效。结果术后随访12~36个月,平均18个月,患者切口愈合良好,无感染,无皮肤坏死。全部患者未见骨不愈合、感染、畸形及再骨折发生。骨性愈合时间4~8个月,平均6个月。采用Johner-Wruhs评定标准:优15例,良2例,差1例。结论采用交锁髓内钉内固定加髂骨植骨治疗胫骨骨缺损操作简单且效果良好,临床疗效满意。

Objective To evaluate the application of interlocking intramedullary nail combined with iliae bone graft and its effect in the treatment of tibial bone defects. Methods A retrospective analysis was carried out on 18 patients admitted from Feb. 2009 to Oct. 2013 fixed by interlocking intramedullary nail combined with iliae bone grafting. All 18 patients with tibial defects were injured from trauma. Among them 12 were males and 6 were females with an average of 42（31-67） years. Surgeries were carried out 2-41 average,3） months after injury. Joh- ner-Wruhs evaluation criteria was employed to assess the postoperative efficacy. Results After surgery, patients were followed up for 12 to 36 （ average, 18 ） months. Incisions healed without infection or skin necrosis. All patients healed with no nonunion, infection, deformity or re-fracture. Bone healing time was 4 to 8 （ average ,6 ） months. According to Johner-Wruhs evaluation criteria, 15 cases were excellent,2 cases were good and 1 case was poor. Condusion Interlocking intramedullary nail combined with iliac bone graft for tibial defects is simple and effective with satisfactory clinical results.