非扩髓交锁髓内钉治疗开放性胫骨干骨折

目的:评估非扩髓交锁髓内钉治疗开放性胫骨干骨折的疗效。方法:应用非扩髓交锁髓内钉治疗21例开放性胫骨干骨折。男18例,女3例,年龄23岁～59岁,平均36.3岁。AO/ASIF分类A型10例,B型9例,C型2例。Gustilo分类Ⅰ型9例,Ⅱ型11例,ⅢA型1例。结果:所有患者得到4～21个月随访(平均14.3个月)。所用髓内钉直径平均8.9mm。骨折平均愈合时间27周(13～34周)。采用Johner-Wruh评分,结果优14例,良6例,差1例,无感染,无断钉和骨不连。结论:非扩髓交锁髓内钉治疗开放性胫骨干骨折,只要严格掌握适应证和手术时机,彻底清创,熟练掌握操作技术,具有创伤小、能早期活动、骨折愈合率高和感染率低等优点。

Unreamed intramedullary interlocking nail in the treatment of open fractures of the tibia shaft

Objective;To evaluate the curative effects of unreamed intramedullary interlocking nail in the treatment of open fractures of the tibia shaft. Methods:Summarized 21 cases of open fractures of the tibia shaft treated by the unreamed intramedullary interlocking nail. All cases were commented by fracture type, operative method, treatment after operation and curative effects. Results:All cases were followed up from 4 to 21 months (average 14. 3 months). The average diameter of the nail was 8. 9 millimeters (range, 8 ~ 10 millimeters). The average time to union was 27 weeks (range, 13~34 weeks). All cases were evaluated according to the criteria of johner and Wruh. The results showed excellent in 14, good in 6 and bad in 1, no infections, no implant failure and non-union. Conclusions: The application of the unreamed intramedullary interlocking nail in the treatment of open fractures of the tibia shaft has advantages of less trauma, early motion can be obtained, high healing rate and low infection rate when the opportunity of operation and indications was grasped, complete debridment and the skill of operation was possessed expertly.