带锁髓内钉治疗178例长骨骨折疗效分析  

Treatment of 178 patients of long bone fractures with interlocking intramedullary nailing

作　　者：程义权[1] 郭振河[1] 杨家辉[1] 余伦红[1] 

机构地区：[1]解放军第161中心医院骨科,湖北武汉430010

出　　处：《西南国防医药》2008年第1期56-58,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的：探讨带锁髓内钉治疗股骨、胫骨和肱骨骨折的疗效。方法：回顾性分析2001年1月至2007年6月我科收治的178例应用带锁髓内钉内固定治疗长骨骨折患者的临床资料。其中新鲜骨折153例（开放性40例，闭合性113例），陈旧性骨折25例；股骨骨折98例，胫骨骨折58例，肱骨骨折22例；男性142例，女性36例；年龄15-84（48．3±16．4）岁。术中应用“C”型臂或“G”型臂引导闭合复位，对部分闭合复位失败者采用切开复位内固定，陈旧性骨折和骨折粉碎严重的病例行断端植骨，取自体髂骨植骨或自体髂骨加固混合植骨。结果：178例骨折均治愈，治愈率为100．0％；骨折平均愈合时间为（18．5±3．2）w，其中正常时间愈合167例（93．8％），延迟愈合9例（5．1％），2例骨折9个月内不愈合（1．1％）；内固定失败6例，其中主钉断裂2例，主钉合并远端锁钉断裂1例，远端锁钉退出1例，近端锁钉退出2例；感染2例（1．2％），外伤性骨折2例（1．2％）。结论：应用带锁髓内钉治疗股骨、胫骨和肱骨骨折愈合率高，并发症发生率低，是治疗骨干骨折的一种较为理想的内固定方法。Objective：To evaluate the clinical results of long bone （including femoral, tibial and humeral bone） fractures treated with locked intramedullary nailing. Methods： 178 cases of long bone fractures treated with locked intramedullary nailing from January, 2001 to June, 2007 were reviewed retrospectively. There were 153 cases of fresh fractures （40 open fractures and 113 close fractures） and 25 ones of old fractures. The sites of the fractures were 98 cases in the femur, 58 in the tibia and 22 in the humerus. 142 patients were male and 36 patients were female. Their average age was （48.3±16.4） years old. Both closed reduction and open reduction methods were used in the operation based on the fracture conditions. Bone grafts of the broken ends of fractured bone were used in the old fracture and thrypsis. Results：All of the 178 bone fractures healed well. The healing rate was 100.0%（178/178）. The average healing time was 18. 5±3.2 weeks. 167 patients（93. 8%） healed normally, 9 patients（5.1%）healed later and 2 patients（1. 1%） were disunion within 9 months. Internal fixation failed in 6 patients. 2 patients were infected. 2 patients had another fractures after operation. Conclusion： Locked intramedullary nailing is one of the good methods of treating long bone fractures and it has a high union rate and a low complication rate.

关 键 词：骨折 内固定术 带锁髓内钉 

分 类 号：R683[医药卫生—骨科学]