闭合复位交锁髓内钉治疗胫骨中下段骨折

目的探讨闭合复位交锁髓内钉内固定治疗胫骨中下段骨折的临床应用效果。方法采用闭合复位交锁髓内钉治疗胫骨中下段骨折46例,所有病例均不扩髓,复位后相对稳定骨折采用动力性固定,斜形或粉碎性骨折早期采用静力性固定,术后早期辅以CPM等进行康复治疗。结果随访病例42例,随访时间6~18个月,按胫骨骨折Johner-Wruhs结果评定标准[1]:优36例,良5例,可1例,优良率98%。结论闭合复位交锁髓内钉治疗胫骨中下段骨折具有创伤小,术中出血少,稳定性好,功能恢复快,骨折愈合率高,并发症少等优点。

INTERLOCKING INTRAMEDULLARY NAILING WITH CLOSE REDUCTION FOR MID- INFERIOR SEGMENT FRACTURE OF TIBIA

Objective To explore the clinical therapeutic efficacy of interlocking intramedullary nailing with close reduction on the mid-inferior segment fracture of tibia. Methods Totally 46 cases of mid-inferior segment fracture of tibia were treated with unreamed interlocking intramedullary nail with close reduction. After the reduction, the cases of relatively stable fracture were performed dynamic fixation, while those cases of oblique fracture and comminuted fracture were performed early static fixation. Early continuous passive motion (CPM) was prescribed postoperatively for the rehabilitation. Results Forty-two cases were followed up for 6~18 months and their recovery were evaluated according to the Johner and Wruhs criteria for tibia fracture. There were 36 cases of excellent union, 5 cases of good union and 1 case of satisfactory union with an excellent and good union rate of 98%. Conclusion Interlocking intramedullary nailing with close reduction for mid-inferior segment fracture of tibia has advantages of noninvasiveness, less perioperative bleeding, good stability, quick function recovery, high rate of fracture union and less complication.