带瞄准装置的交锁髓内针在下肢骨折中的应用(附76例报告)

Application of home-made interlocking intramedullary nails with aiming devices in treatment of femur and tibia fractures

目的总结使用带锁髓内针治疗股骨、胫骨骨折的临床经验。方法回顾性分析从1998年6月～2001年1月所做带锁髓内针治疗股骨和胫骨骨折的病人76例,其中股骨30例,胫骨46例,均为闭合性骨折。术中股骨均采用开放复位,胫骨闭合复位26例,开放复位20例,未使用C型臂X光机透视。术后病人即刻行邻近关节功能活动锻炼。结果30例股骨干骨折3个月内临床骨愈合;46例胫骨骨折6个月临床愈合。胫骨、股骨病人中有30例远端锁钉未能锁上,无断钉断针及感染发生。全部病人术后关节功能恢复达正常的90%～100%。结论操作简单,不需电视X光机透视,易于推广。内固定稳定可靠,抗疲劳度好,能早期行功能锻炼,最大限度的恢复肢体功能。

Objective To summarize our experiences in treatment of the f emur and tibia fractures by means of home-made interlocking intramedullary nail s with aiming devices. Methods 30 cases of femur fractures and 46 cases of tibi a fractures were treated by means of home-made interlocking intramedullary nail s with aiming devices. The therapeutic outcomes were analyzed retrospectively. A ll the femur fractures were managed with open reduction, while 26 cases of tibia fractures were managed by reduction of close-nailing and the other 20 by open-nailing. All the reductions were performed without the aid of X-ray. Patients treated by this method were encouraged to do functional exercises right after t he operation. Results Clinical healing of the 30 cases of femoral fractures was achieved within 3 months, and that of the tibia fractures within 6 months. The distal interlocking failures occurred in 30 cases, but no nail breaking or infec tion happened. 90 % or above of the normal joint functions restored in all the patients. Conclusions Interlocking intramedullary nails with aiming devices ar e easy to handle, and needless of X-ray in the treatment of lower extremity fra ctures. As a stable, high fatigue-resistance inner fixation device, its clinica l application can provide patients with possibly maximum functional restoration.