胫骨的解剖特点与交锁髓内钉治疗多段粉碎性骨折  

The anatomic features of tibia and the treatment of tibial multi-segmental comminuted fracture with interlocking intramedullary nail

作　　者：张健荣[1] 卢尔海[1] 

机构地区：[1]江门市新会人民医院骨科,广东江门529100

出　　处：《中国临床解剖学杂志》2005年第3期323-325,共3页Chinese Journal of Clinical Anatomy

摘　　要：目的:探讨交锁髓内钉治疗胫骨干多段粉碎性骨折的技术方法。方法:回顾性总结采用交锁髓内钉治疗胫骨干多段粉碎性骨折,共38例42肢,男26例,女12例,年龄18～86岁,平均36.2岁,按Gastilo分类,ⅢA24例27肢,ⅢB14例15肢,其中累及骨干上下端18例,采用骨干上下端骨折直接复位简易内固定后,骨干骨折间接复位,交锁髓内钉固定,恢复小腿的长度、轴线及纠正旋转畸形。术后当天作肌肉等长收缩,3d以后作关节活动功能锻炼。结果:随访32例,随访时间6～23个月,平均13.2个月,拟Johner-Wish评分标准:优24例,良5例,中2例,差1例。结论:对于胫骨多段粉碎性骨折,上下端骨折能加用简易内固定,重建≥35mm髓腔后应用交锁髓内钉治疗,效果良好。objective: To explore the technique for treating multi-segmental comminuted fracture of tibia with interlocking inframedullary nail. Methods: 42 legs treating with interlocking inframedullary nail from thirty-eight patients (26 males, 12 females with age from 18 to 86 years old, average 36.2) were summarized retrospectively. According to Gastilo classification, IIIA were 27 cases (27 legs), IIIB 14 cases (15 legs). All patients were treated with open reduction to regain length of legs and the axial line of the tibia before taking internal fixation using interlocking inframedullary nail. All patients started functional recovery at the first day after operation. Results: 32 patients were followed up for 6-23 months with average of 13.2 months, according to Johner-wish standard. Functional recovery of 29 cases was well, 2 cases better, only 1 case had malfunctional recovery. Conclusions: Most patients having complicated fractures of tibia without infection can be treated with interlocking inframedullary nail after reconstructing medullary cavity. The results are satisfactory.

关 键 词：髓内钉 胫骨干 复杂性骨折 骨折固定术 

分 类 号：R683.42[医药卫生—骨科学]