可膨胀髓内钉治疗四肢长骨骨折的疗效分析  

The clinical effect of the expandable intramedullary nailing in fractures of upper and lower extremities

作　　者：喻鑫罡[1] 夏荣刚[1] 陈旸[1] 李晓林[1] 曾炳芳[1] 

机构地区：[1]上海交通大学附属第六人民医院骨科,上海200233

出　　处：《临床骨科杂志》2011年第2期177-179,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨可膨胀髓内钉治疗四肢长骨骨折的疗效。方法采用可膨胀髓内钉治疗四肢长骨骨折45例（52侧）,其中5例术前出现下肢深静脉血栓者安装静脉滤器后手术。结果手术时间30-140（70±6.2）min。45例均获随访,时间12-34（18.6±1.2）个月。骨折愈合时间10-28（11.9±1.3）周。3例出现骨不连后更换钢板植骨固定后愈合,2例髓内钉膨胀失败延迟愈合,7例出现骨不连更换交锁钉植骨固定后愈合。骨折总愈合率达80.7%。结论可膨胀髓内钉治疗四肢长骨骨折具有手术创伤小、操作简单、并发症少的特点,且轴向弹性固定加速骨折的愈合时间,适用多发骨折患者的治疗。Objective To assess the efficacy of the expandable intramedullary nailing for fractures of upper and lower extremities.Methods 45 cases（included 52 extremities）of long bone fractures involved upper and lower extremities were treated by using expandable intramedullary nails.5 cases received inferior vena cava filter because of deep vein thrombosis before the operation.Results Operative timing was from 30 to 140 minutes（average 70±6.2 minutes）.All cases were followed up for 12 to 34 months（average 18.6±1.2 months）.The healing time ranged from 10 to 28 weeks（average 11.9±1.3 weeks）.3 cases were healed by plate fixation and bone graft because of bone non-union.2 cases showed delay-union because intramedullary nails expanded noneffectively.7 cases were transfered to inter-locking medullary nailings because of bone non-union.The general healing rate was 80.7%.Conclusions Fractures involved of upper and lower extremities can be treated by expandable intramedullary nailing,with the characteristic of less invasive,few complications and ease of application,and elastic and axial fixation accelerated fracture healing,especially in polytraumas and multi-fractures.

关 键 词：四肢骨折 可膨胀髓内钉 骨折愈合 

分 类 号：R683.4[医药卫生—骨科学] R687.33[医药卫生—外科学]