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小腿双向牵引器辅助闭合复位髓内钉固定成人胫骨干骨折
引用本文:姚勇 吴昊 田世坤 杨安忠 鄢建新 李磊. 小腿双向牵引器辅助闭合复位髓内钉固定成人胫骨干骨折[J]. 生物骨科材料与临床研究, 2020, 17(3): 70-72
作者姓名:姚勇 吴昊 田世坤 杨安忠 鄢建新 李磊
摘    要:目的 研制小腿双向牵引器,使胫骨干骨折闭合复位髓内钉固定简单易行,降低手术难度。方法 胫骨干骨折患者分为两组:常规组采取常规闭合髓内钉手术方法;双向牵引器组术中膝关节半伸直位,在平腓骨小头前缘或股骨髁打入4.0~5.0 mm斯氏针1枚,在跟骨或胫骨下端打入5.0~6.0 mm斯氏针1枚,克氏针分别装入上下插销装置,调节好双侧纵行撑开杆的撑开螺母,调整骨折复位需要的牵引长度及侧方移位角度,调节插销装置的深度及骨折断端复位需要的旋转角度,之后固定插销和克氏针,进行髓内钉植入手术。比较常规组和双向牵引器结合髓内钉内固定组的手术时间、透视次数、复位优良率。结果 双向牵引器结合髓内钉内固定组较常规闭合髓内钉手术在治疗胫骨干骨折手术时间、透视次数和复位优良率具有优势。结论 小腿双向牵引器降低了手术难度,减少了手术时间和X线透视次数,提高了胫骨干骨折固定的优良率。

关 键 词:胫骨干骨折  髓内钉  小腿双向牵引器

Closed reduction assisted by bi-directional tractor and intramedullary nailing for adult tibial shaft fracture
Yao Yong,Wu Hao,Tian Shikun,Yang Anzhong,Yan Jianxin,Li Lei.. Closed reduction assisted by bi-directional tractor and intramedullary nailing for adult tibial shaft fracture[J]. Orthopaedic Biomechanics Materials and Clinical Study, 2020, 17(3): 70-72
Authors:Yao Yong  Wu Hao  Tian Shikun  Yang Anzhong  Yan Jianxin  Li Lei.
Abstract:Objective To develop a bi-directional tractor for tibial shaft fracture, which can make closed intramedullary nailing for intra-articular distal tibial fractures easier and reduce the difficulty of operation. Methods Patients with tibial shaft fracture were divided into two groups. Patients in normal group accepted routine closed intramedullary nailing operation. The knee joint was semi-extended during bi-directional traction. A 4.0-5.0 mm stern pin was inserted into the anterior edge of the capitulum of the fibula or the femoral condyle, and a 5.0-6.0 mm stern pin was inserted into the lower end of the calcaneus or tibia. The Kirschner pin was inserted into the upper and lower end of the tibia respectively. The opening nuts of bilateral longitudinal support rods was adusted correctly, the traction length and lateral displacement angle was measured for fracture reduction, the depth of the pin device and the rotation angle was tune-up for fracture reduction, and then the pin and Kirschner wire for intramedullary nail implantation was fixed exactly. The operation time, fluoroscopy times and reduction rate of the conventional group and the two-way tractor combined with intramedullary nail fixation group were used for comparison. Results The two-way tractor combined with intramedullary nail fixation group had advantages over the routine closed intramedullary nailing operation in the aspects of operation time, fluoroscopy times and reduction rate of tibial shaft fracture. Conclusion The bi-directional leg tractor reduces the difficulty of operation, saves the operation time and X-ray fluoroscopy times, and improves the excellent rate of tibial shaft fracture fixation.
Keywords:Tibial shaft fracture   Intramedullary nail   Trivial bi-directional tractor
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