第三代扩髓带锁髓内钉治疗胫骨干骨折并发症及防治  

Complications and their prevention during the treatment of tibial shaft fractures with third generation reamed locked intramedullary nail

作　　者：赖志军[1] 谢晞衷[1] 谢惠缄[1] 郭汉明[1] 张建民[1] 黄玉良[1] 蔡宏华[1] 

机构地区：[1]广东省惠州市中心人民医院骨科,惠州516001

出　　处：《山西医科大学学报》2003年第3期258-261,共4页Journal of Shanxi Medical University

摘　　要：目的　为了提高带锁髓内钉治疗骨折的效果。方法　总结用第三代扩髓带锁髓内钉治疗 90例胫骨干骨折的并发症 ,男 75例 ,女 15例 ,平均年龄 4 3岁 (17～ 84岁 )。结果　 82例获得随访 ,平均随访时间 14 3个月 ,术中并发症 6例 (7 3% ) ,其中术中骨折 2例 (2 4 % ) ,远端锁钉未穿过锁孔 2例 (2 4 % ) ,胫骨内翻畸形 1例 (1 2 % ) ,胫骨外翻畸形 1例 (1 2 % ) ;术后并发症 7例 (8 5 % ) ,其中胫骨内翻畸形 1例 (1 2 % ) ,骨不连 1例 (1 2 % ) ,伤口感染 3例 (3 7% ) ,髓内钉断裂 1例 (1 2 % ) ,远端锁钉退出 1例 (1 2 % )。结论　带锁髓内钉治疗胫骨干骨折应严格掌握适应证 。Objective To improve the use of interlocking nail. Methods Complications of tibial fractures in 90 patients treated with the third reamed interlocking nail were reviewed. There were 75 males and 15 females. The average age was 43 years (17～84 years). Results Eighty two patients were followed up. The average follow up survey time was 14 3 months. The intraoperative complication rate was 7 3%, including two fractures during the operation(2 4%), misinserting the distal screw in 2(2 4%), varus tibia in 1(1 2%) and valgus tibia in 1(1 2%). The postoperative complication rate was 8 5%, including varus tibia in 1(1 2%), nonunion in 1(1 2%), wound infection in 3(3 7%), nail broken in 1(1 2%) and distal screw loosing in 1(1 2%). Conclusion The complications described here suggest the importance of selections of surgical indications and proper manipulations.

关 键 词：胫骨干骨折 扩髓带锁髓内钉内固定术 并发症 术中骨折 胫骨内翻畸形 胫骨外翻畸形 骨不连 伤口感染 

分 类 号：R683.42[医药卫生—骨科学] R687.33[医药卫生—外科学]