交锁骨髓内钉治疗开放性胫骨干骨折

目的 评价交锁髓内钉治疗开放性胫骨干骨折的疗效。方法 32例 35侧Ⅰ～Ⅲ型开放性胫骨干骨折采用早期彻底清创 ,交锁髓内钉内固定 ,早期合理使用抗生素 ,创面Ⅰ期修复。结果 随访 10～ 18个月 ,30例 33侧 ,骨折临床愈合时间 3～ 8个月 ,平均 3 5个月。伤口Ⅰ期愈合 2 8侧 ,Ⅱ期愈合 5侧。伤口愈合和骨折愈合优 2 2侧 ,良 9侧 ,可 2侧。无骨折愈合后畸型 ,骨延迟愈合或不愈合。结论 早期彻底清创 ,交锁骨髓内钉治疗开放性胫骨干骨折固定稳固 ,利于骨折愈合创面修复 ,早期功能锻炼 ,是一种较好的方法。

股骨近端交锁骨髓内钉治疗股骨粗隆间骨折的护理

目的:探讨股骨近端交锁骨髓内钉(PFN)治疗股骨粗隆间骨折的护理。方法:对我科近3年住院的22例60岁以上股骨粗隆间骨折病人行股骨近端交锁骨髓内钉治疗护理分析。结果:病人能够顺利接受PRN治疗,达到应有的治疗效果,未发现一例护理并发症。结论:PFN手术用时短,出血量少,固定牢靠,便于护理,是治疗股骨粗隆间骨折理想的方法。

股骨干粉碎性骨折的治疗

目的探讨交锁髓内钉或锁定钢板治疗股骨干粉碎性骨折的临床疗效。方法采用微创技术治疗28例股骨干粉碎性骨折患者,16例行交锁髓内钉内固定,12例行锁定钢板内固定。结果患者均得到随访,时间6～24个月。切口均一期愈合,骨折无不愈合和畸形愈合。骨折临床愈合时间:交锁髓内钉组16～24周;锁定钢板组15～22周。根据Kotmert评分,交锁髓内钉组:优10例,良5例,可1例;锁定钢板组:优6例,良5例,可1例。结论股骨干粉碎性骨折治疗需根据骨折情况选择内固定,结合微创技术,均可获得良好的治疗效果。

Treatment of ipsilateral hip and femoral shaft fractures with reconstructive intramedullary interlocking nail

Objective: To evaluate the results of reconstructive intramedullary interlocking nail in the treatment of ipsilateral hip and femoral shaft fractures. Methods: From August 1997 to November 2001, 13 patients were treated with the reconstructive intramedullary interlocking nail. Nine patients were associated with ipsilateral femoral neck fractures, three with ipsilateral intertrochanteric fractures, and one with subtrochanteric fracture. Results: The follow up time was from 6 to 38 months with an average of 14 months. All the femoral shaft and hip fractures healed up well. There was no nonunion of the femoral neck, and only one varus malunion. No patient had avascular necrosis of the femoral head. The average healing time for femoral neck fracture was 4.6 months and for shaft fracture 5.8 months. The joint movement and other functions were fairly resumed. Conclusions: The reconstructive intramedullary interlocking nail, with less trauma, reliable fixation, and high rate of fracture healing, is an ideal method of choice in the treatment of ipsilateral hip and femoral shaft fractures.