交锁髓内钉治疗74例胫骨骨折并发症原因分析

目的　分析交锁髓内钉治疗胫骨骨折并发症的发生原因并提出相应防治措施。方法　自 1998年 5月到2 0 0 2年 10月 ,共用交锁髓内钉治疗胫骨骨折 74例。结果　所有病例经 8～ 12月随访 ,术中出现骨折端的劈裂 3例 ;胫骨结节劈裂骨折 1例 ;大隐静脉损伤 6例。术后出现膝部切口处皮肤坏死 1例 ;膝部疼痛 6例 ;远端锁钉松动退出 6例 ;骨折延期愈合 4例 ,其中成角畸形 1例 ;伤口感染 2例 ;远端锁钉断裂 1例。结论　交锁髓内钉治疗胫骨骨折应注意 :严格掌握适应证、选择适当的手术时机以及细致的手术操作可避免或减少并发症的发生。

Analysis of complications of tibial fracture with interlocking intramedullary nail

Objective To explore the clinical application of interlocking intramedullary nail in treating tibial fracture. Methods The complications of operation and postoperation were analyzed in 74 cases. Results All cases were followed up for 8～12 months (averaged 10 months). During the operation,a split happened to the spot of fracture in three cases, tibial tuberosity fracture in one case and great saphenous vein was injured in six cases. The complications of postoperation included: skin necrosis (one case); knee pain (six cases); the distant locking nail loose (six cases) broken (one case); and wound infection (two cases); the time of bone heeling delayed (four case). Conclusion In treating tibial fracture with interlocking intramedullary nail,the indications ,the proper time for operation and perfect operation should be noticed in order to prevent the complications.