交锁髓内钉治疗合并大面积皮肤撕脱伤的胫骨骨折

Treatment of tibial fracture with big area skin avulsion injury with interlocking intramedullary nail

目的 :探讨交锁髓内钉在治疗合并大面积皮肤撕脱伤的胫骨骨折中的应用。方法 :分析 2 6例合并大面积皮肤撕脱伤的胫骨骨折应用交锁髓内钉治疗临床疗效。结果 :撕脱皮肤全部成活或大部分成活 ,无出现大片感染、坏死 ;骨折无延迟愈合和骨不连 ,关节活动、肢体负重功能完全恢复。结论 :(1)交锁髓内钉 :①能在早期最大限度地为撕脱皮肤的成活提供一个必需的稳定环境 ;②利于护理、早期下床行走 ;(2 )根据软组织和骨折具体情况 ,灵活掌握内固定、创面闭合的时机是手术成功的关键。

Objective: To study the application of interlocking intramedullary nail in tibial fracture with big area skin avulsion injury.Method: Twenty-six patients with tibial fracture with big area skin avulsion injury received interlocking intramedullary nail were analyzed.Result: The avulsion injured skin were all survive or major part survive,without large part inflammation and necrosis.All the fracture had no delay union or nonunion.The patient function of joint action and the limb were completely recovered.Conclusion: 1.Interlocking intramedullary nail: (1)Can provide a necessary and steady environment for the survive of the avulsion injured skin.(2) It is very convenient to nurse and ambulate at an early date.2.It is the key of operation succeed that grasp the opportunity of internal fixation and close wound flexibility according to the concrete conditions of soft tissue and fracture.