扩髓与非扩髓带锁髓内钉治疗开放性胫骨骨折

目的比较扩髓与非扩髓型带锁髓内钉治疗开放性胫骨骨折的临床疗效。方法对86例共92侧开放性胫骨骨折采用带锁髓内钉治疗，其中扩髓组54侧，非扩髓组38侧。伤口拆线后扶拐下地活动，术后定期随访6个月～2年。结果扩髓组与非扩髓组局部感染率分别是20．3％和5．3％（P〈0．05）；扩髓组与非扩髓组平均骨折愈合时间分别为22．5周和19周（P〉0．05）；延迟愈合分别为8例，3例。结论与扩髓组比较，非扩髓带锁髓内钉延迟愈合或不愈合少，感染率低，两组平均骨折愈合时间无明显差异。

Study on the Effects of Open Tibial Fractures Using Reamed or Non-reamed Intramedully Nails

Objective To compare the clinical results of the treatment for open tibia fractures using reamed or non-reamed intramedullary nails. Methods 92 open tibial fractures （86 patients）were treated with intramedullary nails from February 2002 to February 2004,use reamed or non-reamed intramedullary nails at random. Among them 54 in reamed（reamed group） and 38 in non-reamed（non-reamed group）. Patients moved under the support of crutch after wound healing,all patients were followed up from 6-12 month regularly. Results Infection occured 11 cases （20.3%） in reamed group and 2 eases（5.3%） in non reamed group. The average healming time of the fractures was 22.5 weeks in reamed group and 19 weeks in non-reamed. Delayed union occurred 8 cases in reamed group and 3 in non-reamed group;hemorrhage rate 29.6% in reamed group and 5.3% in non-reamed group. Conclusion Compared with reamed intramedullary nails ,non-reamed intramedullary nails can lower the infection rate and less delayed union or nonunion.