逆行钉技术治疗胫骨远端骨折的疗效  

The effect of retrograde intramedullary nail technique for treatment of distal tibial fractures

作　　者：葛振新 张永莲 刘晨 戚昊天 姜钰 荆玉峰 GE Zhen-xin;ZHANG Yong-lian;LIU Chen;QI Hao-tian;JIANG Yu;JING Yu-feng(WardⅠ,Dept of Traumatic Orthopaedics,Juxian Hospital of Qingdao University Medical Group,the People′s Hospital of Juxian,Rizhao,Shandong 276500,China)

机构地区：[1]青岛大学医疗集团莒县医院(莒县人民医院)创伤骨科一病区,山东日照276500 [2]天津市天津医院创伤骨科,天津300000 [3]中国人民解放军总医院第四医学中心创伤骨科,北京100000

出　　处：《临床骨科杂志》2024年第4期571-574,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨逆行钉技术治疗胫骨远端骨折的疗效。方法采用逆行钉技术治疗16例胫骨远端骨折患者。记录手术情况、骨折愈合时间、踝关节活动度及并发症发生情况,采用Johner-Wruhs评分标准评定疗效。结果手术时间50~90(60.42±11.42)min,术中出血量60~100(70.25±9.47)ml。患者均获得随访,时间9~22个月。未发生切口感染、内固定断裂等并发症。骨折均愈合,时间3~10(5.36±2.35)个月。末次随访时,16例下地完全负重,其中14例步态正常,2例由于术后踝关节活动障碍出现轻度跛行;按照Johner-Wruhs评分标准评定疗效:优9例,良6例,可1例,优良率为15/16;踝关节活动度:背伸10°~30°(19.12°±6.98°),跖屈26°~45°(34.19°±7.36°)。结论逆行钉技术治疗胫骨远端骨折可以很好地稳定骨折,提高骨折愈合率,促进关节功能的恢复。Objective To investigate the curative effect of retrograde intramedullary nail for treatment of distal tibial fractures.Methods The 16 cases of distal tibial fractures were treated by using retrograde intramedullary nail technique,the surgical conditions,fracture healing time,ankle range of motion and complications were recorded,and the effect was assessed with Johner-Wruhs scores criterion.Results The operation time was 50~90(60.42±11.42)min,and intraoperative bleeding volume was 60~100(70.25±9.47)ml.All patients were followed up for 9~22 months.No complications such as wound infection and internal fixation fracture occurred.All patients had fracture healing,with the time of 3~10(5.36±2.35)months.At the last follow-up,16 cases could load with full weight-bearing,of which 14 cases had normal gait,and 2 patients had mild claudication due to the ankle movement disorder,and the effect was evaluated with the Johner-Wruhs score criterion,the result was excellent in 9 cases,good in 6 cases,and fair in 1 case,with the excellent-good rate of 15/16.The ankle range of motion was dorsiflexion with 10°~30°(19.12°±6.98°),planter flexion with 26°~45°(34.19°±7.36°).Conclusions Retrograde intramedullary nail technique for treatment of distal tibial fracture can stabilize the fracture well,improve the fracture healing rate,and promote the joint functional recovery.

关 键 词：逆行钉 胫骨远端骨折 

分 类 号：R683.42[医药卫生—骨科学] R687.3[医药卫生—外科学]