带锁髓内针治疗下肢长骨骨折并发症17例

目的：探讨带锁髓内针治疗下肢长骨骨折的并发症及其出现原因、防治措施。方法：回顾性分析2000年9月～2009年9月在应用带锁髓内针过程中出现的并发症17例,包括锁钉失败,骨折延迟愈合,骨折处钢丝捆绑环扎导致骨坏死吸收,深部感染,外旋畸型,髓内针长度的选择及锁钉取出侧别选择失误,锁钉脱落等并发症。结果：对出现并发症的患者采取补救措施,除锁钉失败1例未随访,其余16例均得到随访,随访时间为9～18个月,其中1例锁钉取出错误和1例髓针过短导致骨折不愈合,经更换内固定物,于12个月时愈合,且遗留膝关节僵硬,其余14例患者均达到骨折一期愈合,无后遗症出现。结论：并发症出现的原因多是术者对适应证的掌握、手术熟练程度、技术原因等情况认知程度不够,出现并发症应及时补救,术者应总结经验,降低并发症的发生率。

Complications following interlocking tramedullary nailing of long bone fractures of lower limbs in 17 cases

Objective：To explore the complications and causes of terlocking intramedullary nailing long bone fractures of lower limbs and find measures against them.Methods：Reviewing analyzed of 17 cases of complications in the use of intramedullary terlocking nail between Sept.2000 and Sept.2009.Including unsuccessful application,delayed frature healing,absorption of bone necrosis because of the rings around fractures,deep infection,external rotation deformity,failure in choosing the suitable length of intramedullary nail and the right side to remove the nail and nail shedding etc.Results：Complicatious of patients to take remedial measures,locking failed in cases not followed up,16 cases were followed up 9 to 18 months except one unsuccessful application.Meanwhile,two cases of ununion of which one was because incorrect nail removing and another was because nail being too short healed in 12 months with stiff knee joint.The rest were all follow up to 14 cases primary healing fracture,without sequelae appear.Conclusion：Post-operative complications occur mainly because that the surgeons don＇t know quite well about the indications,operations and related technologies.Thus,surgeons should draw lessons and take remedial measues on time when complications occur in order to reduce the inciednce of complications.