扩髓与非扩髓型带锁髓内钉治疗开放性胫骨骨折的疗效分析

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 2002年4月～2004年4月,对86例(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.男65例,女21例,年龄18～68岁,平均36.5岁.伤口拆线后下地扶拐活动,术后均获随访6个月～2年. 结果 86例获随访6～24个月,扩髓组与非扩髓组分别感染11例和2例,感染率分别为20.3%和5.3%,二者差异有统计学意义(P<0. 05);平均骨折愈合时间分别为22.5和19周,二者差异无统计学意义(P＞0.05);延迟愈合分别有8例和3例. 结论非扩髓带锁髓内钉组与扩髓组比较,具有延迟愈合或不愈合少,感染率低等特点.

Comparative Study on the Effect of Reamed and Nonreamed Intramedullary Nails on Traeting Open Tibial Fractures

Objective To compare the clinical effect of reamed and nonreamed intramedullary interlocking nails on treating open tibial fractures. Methods From February 2002 to February 2004, 92 cases of open tibial fractures (86 patients) were treated with intramedullary interlocking nails. Of the 86 patients, 65 were male and 21 were female. Their age ranged from 18 to 68 years (36.5 on average). Of the 92 cases, 54 were in the reamed group and 38 in the nonreamed group. Patients moved with the support of crutch after their wounds were healed. Results All patients were followed up regularly for 6 to 24 months. Infection rate in the reamed group and nonreamed group was 20.3% and 5.3% respectively, and there was significant difference between them (P<0.05). The average healing time of the fractures was 22.5 weeks in reamed group and 19 weeks in nonreamed group, and there was no significant difference between them (P>0.05). Delayed unions occurred in 8 cases and 3 cases in reamed group and nonreamed group respectively. Conclusion Compared with reamed group, nonreamed intramedullary interlocking nails have lower infection rate and fewer delayed unions and ununions.