髓内钉在治疗股骨、胫骨多段骨折中的应用

目的:探讨交锁髓内钉治疗股骨、胫骨多段骨折的方法与疗效。方法:含累及小粗隆但未延伸至大粗隆的股骨多段骨折使用重建髓内钉,余股骨、胫骨的多段性骨折均采用扩髓交锁髓内钉治疗。结果:经8个月～18个月随访,骨折全部愈合,无锁钉及髓内钉松动、断裂,髋、膝、踝关节功能正常,均无感染,一例因胫前皮肤及软组织缺损重行腓肠肌内侧头肌皮瓣修复皮肤缺损。结论:交锁髓内钉在治疗股骨与胫骨多段骨折中,具有创伤小,固定坚强,骨折愈合率高,能早期活动,感染率低等优点,是治疗股骨与胫骨多段骨折的一种很好的内固定方法,值得临床广泛使用。

Objective:to investigate the method and curative effect of interlocking intramedullary nailing for multi-segment femoral and tibial fracture.Methods:the indication of using reamed intramedullary nailing is multi-segment fracture of femoral and tibia.However.if the fracture involves lesser troehanter and doesn't extend larger trochanter,we would choose reconstruction nail Results:after follow-up for 8～18months,all the fractures attach clinical bone union,no loosing or breakage of interlocking screws and intramedullary nailing.The function of hip and knee and allkle is normal,no infection.One case of defect of the skin and soft tissueneed dermoplasty at second time.Conclusion:the advantnges of using interlocking intramedullary nailing for multi-segment femoral and tibial fraeture are less trauma,stronger fixation,higher bone-union incidence,earlier function exercise and lower infection incidence.As a satisfactory treatment ofinternal ftxtion for multi-segmentfemoral and tibial fracture,we befieve it should be worth to exteusively clinical use.