带锁髓内钉有限切口治疗胫骨骨折

目的探讨带锁髓内钉有限切口治疗胫骨骨折的临床疗效。方法回顾性分析2002年8月～2005年10月应用Orthofix带锁髓内钉固定治疗胫骨骨折256例，术中不扩髓，同时运用骨折端有限切口有利于骨折的复位和植骨。其中男155例，女101例；年龄20-65岁，平均37．2岁。上段95例，中段82例，下段79例；开放性85例，闭合性171例；车祸伤105例，摔伤82例，重物砸伤69例。结果随访6-26个月，平均14月。采用JOHNER—WRUHS评分标准评定：优215例，良35例，差6例，其中4例开放性骨折，因软组织挫伤严重，术后皮肤部分坏死，二期植皮后愈合，无胫骨外露，无断钉及骨不连。骨折平均愈合时间为8．2个月。结论带锁髓内钉有限切口治疗胫骨骨折具有操作方便，固定牢靠，手术时间短及并发症少等优点，是治疗胫骨骨折比较理想的内固定方法，值得推广与应应用。

Fractures of the tibia treated with a limited incision and interlocking intramedullary nail

Objective] To explore the curative effect of interlocking intramedullary nail in the treatment of tibial fracture with limited incision.Methods] From August 2002 to October 2005,256 cases of tibial fracture were treated by Orthofix's interlocking intramedullary nails with limited incisions which profiting to bone grafting and reposition of fracture,and marrow cavity was unreamed.male 155,female 101,aged from 21 to 61,mean age 37.2 years;superior segment 95,midpiece 82,inferior segment 79;open 85,closed 171;road accident 105,getting wound in a fall 82,object crashed 69.Results] All cases were followed up for 6 to 26 months,average 14 months.Scorces of Johner-Wruhs was adopt to evaluate,excellent 215,good 35,bad 5.Among them,4 cases were healed after dermatoplasty because of cutaneous necrosis,which resulted from soft tissue contunded severely for open fracture.No reveal and nonunion of tibia,No locking-screw and nail was loosen or broken.The average time of fracture's heal-ing was 8.2 months.Conclusion] The treatment of tibial fracture with a limited incision and interlocking intramedullary nail is a perfect internal fixation method because of convenient manipulation,firm fixation,short operative time and fewer complications,which is worth to spread and application.