阻挡钉结合生根技术在带锁髓内钉治疗胫骨远端骨折中的应用

目的:介绍一种胫骨交锁髓内钉结合阻挡钉和生根技术治疗胫骨远端骨折的手术方法,并评价初步的临床效果。方法:2006年6月至2011年3月,采用结合阻挡钉和生根技术治疗胫骨远端骨折26例,其中男18例,女8例;年龄24～64岁,平均46.2岁。根据AO分型:A1型10例,A2型号4例,B1型8例,B2型4例。从骨折端到踝关节平均距离为85mm(55～125mm),受伤至手术时间平均4.5d。随访评估患者疼痛度、步态、活动度。结果:26例均获随访,时间6～22个月,平均15个月。采用Iowa踝关节评分系统对踝关节功能进行评估,Iowa评分平均(94.6±4.8)分,较术前(66.8±8.2)分明显提高。所有病例获得稳定固定,未发生骨不愈及断钉。结论:阻挡钉结合生根技术用于交锁髓内钉治疗胫骨远端骨折,具有微创、可改善复位、固定可靠等优点。

Clinical application of blocking screws and rooting technique in the treatment of distal tibial fracture with interlocking intramedullary nail

Objective: To introduce the clinical method of blocking screws and rooting technique in the treatment of distal tibial fracture with interlocking intramedullary nails. Methods:From June 2006 to March 2011,26 patients with distal tibial fracture were treated with interlocking intramedullary nails using blocking screws and rooting technique,included 18 males and 8 females with an average age of 46.2 years old ranging from 24 to 64 years. According to AO classification: 10 cases of type A1,4 cases of type A2,8 cases of type B1,4 cases of type B2. The average distance of the fractures end to the ankle joint was 85 mm ranging from 55 to 125 mm,the mean time between injured and operation was 4.5 days. The patients were evaluated with pain,range of motion,walking. Results:All cases were followed-up for 6 to 22 months (averaged 15 months). According to Iowa ankle joint grading system,the score was improved from preoperative (66.8±8.2) to postoperative (94.6±4.8). All fractures had united,and got satisfactory reduction and stable fixation with no complications had happen such as breakage of screw. Conclusion:Fixation with interlocking intramedullary nail using blocking screws and rooting technique in treating distal tibial fracture,is a safe and effective technique for the improvement of stability.