带锁髓内钉治疗四肢长管状骨骨不连

The Use of Interlocking Intramedullary Nail in Long-Bone Fracture in the Limbs

目的 分析四肢长管状骨陈旧性骨折骨不连的原因及带锁髓内钉治疗的优缺点 ,并与其它方法相比较。 方法 对 35例四肢长干骨陈旧性骨折骨不连、骨延迟愈合的病人施以扩髓、带锁髓内钉固定治疗。在 6～ 8周后改为动力固定的 8例。在 6～ 8个月对X线示骨痂生长不良的 3例中的 2例予以重新扩髓、更换髓内钉 ,1例仅由静力固定改为动力固定。 结果 更换髓内钉的 2例病人共随访 14个月 ,均愈合良好 ;其余病人随访均在半年以上 ,全部愈合 ,平均愈合时间为 2 2周。 结论 带锁髓内钉治疗成人四肢长管状骨陈旧性骨折骨不连、骨延迟愈合与其他方法 (加压钢板、普通钢板、外固定器 )相比有其独特的优点。

Objective[WT5”BZ] To study the causes of old long bone fracture nonunion in the limbs and analyse the advantages and disadvantages in the treatment with the interlocking intramedullary nail;to compare the interlocking intramedullary nail treatment with other therapies. [WT5”HZ]Methods [WT5”BZ]We performed reaming interlocking intramedullary nail fixation to treat nonunion and delayed union of long bone fracture in the limbs of 35 cases. In 8 cases, the nail therapy was replaced by dynamic fixation in 6-8 weeks after the operation. Because of mal up spring callus revealed by radiography in 6-8 months after the operation, 2 cases were rereamed and changes were made in the interlocking intramedullary nail. Only 1 case was changed to dynamic fixation.[WT5”HZ] Results[WT5”BZ] The 2 cases with the change of the interlocking intramedullary nail healed well for a follow up of 14 months. And the healing rate of the other cases was 100% for a follow up of more than 6 months. The average healing time was 22 weeks.[WT5”HZ] Conclusion [WT5”BZ]Of the therapies (steel plate,common intramedullary nail,and external fixator) for old limb long bone fracture nonunion and delayed union,the interlocking intramedullary nail has its own particular advantages. [WT5”HZ]