IM型膨胀自锁髓内钉治疗四肢中段骨干骨折

目的总结IM型Fixion系统膨胀自锁髓内钉治疗简单四肢中段骨干骨折经验,分析其优缺点,扩展对骨折的治疗方式.方法 2008年6月至2009年2月对24例简单四肢骨干中段骨折病例采用IM型膨胀髓内钉治疗,全部均为新鲜创伤性骨折,男19例,女5例,年龄19～66岁,肱骨6例,股骨11例,胫骨7例,观察手术时间、出血量、透视时间、移位幅度等.结果骨折复位固定后未见异常活动及旋转、分离位移,手术时间31～115min,平均57min;术中出血40～300mL,平均88mL;术中透视2～11次,切口均一期愈合,术后3d开始相邻关节功能锻炼,未发现脂栓、深静脉血栓、内固定失效等并发症,术后5～14d出院,随访6月以上病例骨折均已愈合.结论 IM型Fixion系统膨胀自锁髓内钉治疗四肢骨干中段骨折具有手术时间短、出血少、射线暴露少、创伤小、固定可靠等优点,是临床医师的较好选择之一,值得推广.

IM Expandable Intramedullary Nail System in Treating Diaphyseal Fractures of Extremities

Objective To summarize the experience of treatment of midpiece diaphyseal fracture of extremities with IM expandable intramedullary nail system,to analyse the advantages and disadvantages,and to spread the strategies for fracture.Methods 24 cases of simple diaphyseal fractures of extremities were treated with expandable nail from June 2008 to February 2009.Among the patients,there were 19 male and 5 female patients,the age of patients was 19-66,there were 6 cases of humerus,11 cases of femur,and 7 cases of tibia. The operation time,the volume of blood loss,the X-ray examination time and shifting extent were observed. Results The axial direction and rotation displacement were not observed after fixation.The time of operation was 31-115 minutes,57 min averagely.The volume of blood loss during operation were 40 ～300 mL,88 mL averagely.The X-ray examination during operation was conducted 2-11 times.The incision were primary healing.The functional exercise of articulations were enforced after 3 days to operation.The oil embolism,DVT,pneumonia,urinary tract infection,refractoriness of nail and disunion of fracture were not found.All patients were discharged in 5-14d after operation,and were healed after 6 months of follow-up.Conclusion The advantages of IM expandable intramedullary nail system include short operation time,slight hemorrhage,olig-exposure in X-ray,free-enlarging medullary cavity,minimal trauma and assured fixation.The method to treat simple midpiece diaphyseal fractures of extremities is worth to be generalized.