带锁髓内钉临床应用的并发症及预防  

Complication and its prevention of interlocking intramedullary nails

作　　者：杨云平[1] 杨轲颖[1] 王宇飞[1] 陆晓涛[1] 李光全[1] 

机构地区：[1]云南省第二人民医院骨科,云南昆明650021

出　　处：《临床骨科杂志》2005年第3期235-237,共3页Journal of Clinical Orthopaedics

摘　　要：目的分析带锁髓内钉临床应用并发症的产生原因并提出预防措施。方法随访带锁髓内钉治疗股骨、胫骨骨折患者385例,观察带锁髓内钉应用后出现的77例并发症,并进行相应的治疗。结果术中并发症包括入钉点错误(30例)、锁钉沉、浮钉(22例),共52例;术后并发症包括小腿旋转畸形(3例)、骨延迟愈合(12例)、骨不连(4例)、迟发性感染(2例)、关节僵硬(4例)共25例。治疗后,并发症均治愈,功能得到改善。结论熟练的手术操作和严格的手术适应证是预防带锁髓内钉应用后并发症的关键。Objective To analyze the causes of complications of long bone fractures treated with interlocking intramedullary nails. Methods 385 cases of femoral or tibial fractures were treated with interlocking intramedullary nails, of which 77 cases got complications and received correspondant treatment. Results 52 cases of intraoperative complications including 30 wrong localization of interlocking site and 22 wrong locking bolt trajectory selection were enrolled. 25 cases of postoperative complications included inversion of tibia in 3 cases, nonunion in 4 cases, delayed unions in 12 cases, delayed infection in 2 cases and stiffness of knee joint in 4 cases. All were cured after treatment and got the function improvement. Conclusions Both proper manipulations and strict indications selection for surgical treatment are vital to prevent the complications.

关 键 词：股骨骨折 胫骨骨折 骨折固定术 髓内 带锁髓内钉 

分 类 号：R683.42[医药卫生—骨科学] R687.33[医药卫生—外科学]