交锁髓内钉在股骨、胫骨干骺端骨折中的应用

目的 探讨交锁髓内钉在股骨，胫骨干骺端骨折中的应用。方法 回顾性分析1999年5月-2001年7月行股骨，胫骨干骺端骨折交锁髓内钉固定术的患者18例，8例股骨骨折中，骨折线位于小转子以上2例，股骨髁面4-6cm以内6例，其中累及膝关节2例。交通伤15例，坠落伤2例，摔伤1例。根据临床疗效综合评价该手术方式的可能性。结果 术后无一例发生伤口感染，骨不连，关节功能障碍等并发症，随访6-24个月，平均18个月，股骨近，远端骨折，胫骨远端骨折平均愈合时间分别为12周，13周，14周，16周，所有骨折均愈合，术后6个月均弃拐行走，评价按Johner-Wruch标准；优良17例，1例畸形愈合，优良率为94%。结论 在股骨，胫骨干骺端骨折使用交锁髓内钉疗效满意，扩大了交锁髓内钉的适应证。

Use of intramedullar interlocking nail in femoral and tibial metaphysis fractures

Objective To observe the clinical use of intramedullar interlocking nail (IIN) in treatment of femoral and tibial metaphysis fractures. Methods We retrospectively studied 18 cases with femoral and tibial metaphysis fracture treated by interlocking nail. In 8 cases femoral fracture, there were 2 cases' femoral fracture line above the lesser trochanter, and 6 cases' fracture line lying in 4-6 cm to condylar surface including 2 cases' fracture line range to knee joint. There were 15 cases of traffic trauma, 2 fall injury and 1 slip injury. We could evaluate the feasibility of such kind of operation based on clinical therapeutic effect and Johner-Wruch standard. Results After operation, there did not exist infection, fracture nonunions or joint function disorder complication. Of the 18 patients underwent the described procedure and follow-up for a mean of 18 months (6-24 months), the average time for healing of femoral proximal, distal fracture and tibial proximal, distal fracture was 12 weeks, 13 weeks, 14 weeks and 16 weeks respectively. All cases could walk without crutch. Seventeen cases obtained satisfactory results, one had malunion with an excellent rate of 94%. Conclusions The IIN is found to be effective in the treatment of femoral and tibial metaphysis fractures. We have broadened the indications of the IIN.