带锁髓内钉治疗胫骨骨折(附76例报告)

Tibial fractures treated with interlocking intramedullary nail(report of 76 cases)

目的 总结带锁髓内钉治疗胫骨骨折的经验。方法 采用带锁髓内钉内固定的不同类型的胫骨骨折 76例。其中闭合骨折 5 5例 ,开放骨折 2 1例。 76例平均随访时间 17.9个月 ( 4～3 1个月 )。疗效评定采用Johner -wruh评分标准。结果在 5 5例闭合骨折中 ,优 49例 ,良 5例 ,中 1例 ;2 1例开放骨折 ,优 17例 ,良 3例 ,差 1例。术后均无继发性骨筋膜室综合征 ,无神经损伤、钉体断裂和感染。结论 带锁髓内钉适用于治疗胫骨骨折 ,非扩髓带锁髓内钉适于开放骨折和多发伤 ;早期手术并不影响预后 ,且可减少并发症。

Objective To analyse fracture of the tibia treated with a intramedullary interlocking nail.Methods 96 unstable fractures of the tibia treated with a reamed intramedullary interlocking nail were reviewed.There were 55 closed and 21 open fractures.76 cases were followed-up for an average of 17.9 months (ranged 4 to 31 months) and evaluated according to the criteria of Johner and Wruh.Results In the closed cases,there were 49 assessed as excellent,5 as good and 1 as fair.In the open cases,there were 17 assessed as excellent,3 as good and 1 as poor.There was no postoperative compartment syndromes,neurological deficits,broken nails and screws in this cases.Conclusions The interlocking intramedullary nail is indicated for the tibia fractures,and early operation is feasible.The nonreamed interlocking intramedullary nail is suitable for open fractures and multiinjuries.