髓内钉动力化在促进长骨愈合中的应用与争议  

Application and controversy concerning dynamization of interlocking intramedullary nails to facilitate healing of long bone fracture

作　　者：闫旭 梅炯[1] Yan Xu;Mei Jiong(Department of Orthopeadics,The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University,Shanghai 200233,China)

机构地区：[1]上海交通大学附属第六人民医院骨科,200233

出　　处：《中华创伤骨科杂志》2020年第8期733-736,共4页Chinese Journal of Orthopaedic Trauma

摘　　要：长骨髓内钉固定动力化的临床应用一直存在争议。有学者认为,髓内钉动力化可以促进长骨骨愈合,是治疗长骨干,尤其是胫骨、股骨延迟愈合及骨不连的一种有效手段;也有学者认为,髓内钉动力化可能会加重骨折端的不稳定,并不利于骨折愈合。了解髓内钉动力化影响骨折愈合的机制,掌握髓内钉动力化的最佳时机以及使用合理的髓内钉动力化方法有利于提高骨折愈合率、减少并发症。本文就髓内钉动力化促进骨愈合的机制、髓内钉动力化的时机以及这项技术引起的争议等问题作一简要综述。Controversy exists concerning clinical application of dynamization of interlocking intramedullary nails.Some scholars believe that dynamization of interlocking intramedullary nails is an effective therapy for delayed union and nonunion of long bones,the tibia and the femur in particular,because it may promote healing of long bones.However,some hold that the dynamization may detriment fracture healing because it deteriorates the instability of the fracture ends.It helps foster the rate of fracture healing and reduce complications to understand the impact of dynamization on fracture healing,proper timing of the dynamization,and rational application of the dynamization methods.This review expounds the research progress in dynamization mechanisms,optimal timing of the dynamization and controversy over the treatment strategies.

关 键 词：生物力学 骨折 不愈合 骨钉 交锁髓内钉动力化 骨延迟愈合 

分 类 号：R687.3[医药卫生—骨科学]