外固定支架与交锁髓内钉序贯联合应用治疗复杂胫骨干骨折

①目的评价外固定支架与交锁髓内钉序贯联合应用治疗复杂胫骨干骨折的效果。②方法19例病人22个复杂胫骨干骨折初期应用外固定支架先行临时固定，后按计划接受交锁髓内钉治疗。③结果外固定支架使用时间平均为10d(3～49d)。所有病人骨折均愈合，平均愈合时间为7个月(4～10个月)，其中2例病人接受了交锁髓内钉的动力化，将长骨折段的锁钉去除。还有2个肢体出现锁钉断裂，但骨折最终愈合。没有出现交锁髓内钉置换后的深部感染。④结论对于复杂的胫骨干骨折外固定支架与交锁髓内钉序贯联合应用是一种非常有效的、安全的治疗方法。

EXTERNAL FIXATION AND SECONDARY INTRAMEDULLARY NAILING IN COMPLICATED TIBIAL FRACTURES

Objective To evaluate the effect of secondary intramedullary nailing after external fixation in the treatment of complicated tibial fractures. Methods From 1999 to 2002, 19 complicated fractures of the tibial shaft were treated by external fixation followed by intramedullary nailing. Results The average duration of external fixation was 10 days(3-49 days). All fractures healed, with an average duration of seven months. The nails in the long bone of two patients were removed. The nails broke in another two patients, but the fractures healed in the end. No deep infection occurred following the replacement of intramedullary nails. Conclusion Immediate external fixation followed by early closed interamedullary nailing is safe for the treatment of complicated fractures of the tibial shaft.