扩张自锁髓内钉与交锁髓内钉治疗胫骨干闭合骨折的临床比较研究  

Comparative Research on Sclf-llock Expandable Intramedullary Nail and Interlocking Intramedullary Nail in Treatment of Tibial Shaft Closed Fractures

作　　者：王乃集 张大闯 郑圣鼐 王黎明[2] 姚庆强[2] 孙达锋[2] 时梦骁[2] 徐燕[2] 

机构地区：[1]江苏省宿迁市分金亭医院骨科,223120 [2]南京医科大学附属南京第一医院骨科

出　　处：《中国骨与关节损伤杂志》2010年第9期794-796,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的对比髓内扩张自锁髓内钉固定术(self-locking expandable intramedullary nail)与交锁髓内钉内固定术(interlocking in-tramedullary nail)治疗胫骨干闭合骨折的临床结果,并探讨髓内扩张自锁髓内钉技术要点。方法治疗胫骨骨折31例,其中自锁髓内钉组15例,交锁髓内钉组16例。记录手术时间、术中出血量、术中X线机透视次数、术中术后并发症、下地时间,骨折愈合时间、术后1年膝关节KSS评分结果。结果随访15～21个月。自锁髓内钉组、交锁髓内钉组手术时间分别为[(32±17)min,(58±21)min,P<0.05]、术中出血量[(71±25)ml,(145±31)ml,P<0.05)]、术中X线透视次数[(6±2)次,(14±6)次,P<0.05)],术中术后并发症发生率、下地时间、骨折愈合时间、术后1年膝关节KSS评分无显著性差异。结论胫骨干闭合骨折是髓内扩张自锁髓内钉固定术的适应证,该术较交锁髓内钉术更微创,手术时间短,治疗效果与交锁髓内钉术大致相当,但其远期效果需要进一步临床研究。Objective To investigate and discuss the feasibility and clinical outcome of self-locking expandable intrameduUary nail and interlocking intramedullary nail in the treatment of tibial shaft closed fracture. Methods Thirty-one cases were recorded. In self-locking expandable intramedullary nail group, 15 cases were operated. In interlocking intramedullary nail group, 16 cases were operated. Time of operation, the intra-operative blood loss, the rate of complications, time of leave bed, time of bone union, the KSS score of knee were recorded.Results The patients were followed up from 18 to 25 months with an average of 21 months. The time of operation in group of self-locking expandable intrameduUary nat group was （32±17） min, while in group of interlocking intrameduUary nail group was （58±21） min,P〈0.05,the intra-operative blood loss in the two group was （71±25） ml,（145±31） ml,P〈0.05; the number of X-ray fluoroscopy times was 6±2,14±6,P〈0.05. There were no statistical difference in the perioperative complications, the time of leave bed, the time of bone union, and the KSS score of knee in the two group.Condusion It may be an appropriate technique to use serf-locking expandable intrameduUary nail to treat tibial shaft closed fracture, and the outcomes of the self-locking expandable intramedullary nail is better than the interlocking intramedullary nail. But its long-term effects are worthy of further clinical research.

关 键 词：髓内扩张自锁钉 交锁髓内钉 胫骨干骨折 

分 类 号：R683.42[医药卫生—骨科学]