前臂交锁髓内钉治疗尺桡骨粉碎骨折的临床研究

目的探讨应用前臂交锁髓内钉治疗尺桡骨粉碎性骨折的可行性及其疗效。方法应用前臂交锁髓内钉采用切开或闭合复位技术治疗尺桡骨粉碎性骨折18例,男15例,女3例;年龄32～63岁,平均42岁。骨折按AO分型,A 1型4例,A 2型1例,A 3型2例,B 2型1例,B 3型3例,C 2型3例,C 3型4例。手术均在伤后1周内进行。结果所有病例术后随访8～10个月,骨折愈合时间8～16周,平均12周。所有患者均未发生骨不连、术后感染及桡神经深支损伤病例;术后有2例前臂旋转功能恢复欠佳,1例骨折延迟愈合,其余患者功能恢复满意。根据B erton评定标准进行评价,优10例,良5例,可2例,差1例,优良率为83.3%。结论应用前臂交锁髓内钉技术治疗尺桡骨骨折,具有手术创伤小、固定牢靠、骨折愈合率高、功能恢复快等优点,是治疗前臂骨折较理想的手术方法,尤其适用于多段骨折、粉碎性骨折。

Clinical Study of Treatment of Comminuted Forearm Fratures Using Interlocking Intramedullary Nailing

Objective The purpose of our study was to evaluate the feasibility and efficacy of treatment of comminuted forearm fractures using interlocking intramedullary nailing.Methods 18 cases of comminuted forearm fractures were treated with open or closed reduction using forearm interlocking intramedullary nailing manufactured by Smith-Nephew company.Radiologic and clinical results were evaluated.Results All cases were followed-up for 8 to 10 months to evaluate the curative effect.The average time of union of fracture was 12 weeks（8-16 weeks）.Nonunion,infection and deep branch of radial nerve injury were not observed in all cases. All patients but two have salisfactory functions of forearm rotation and one was delayed union. Conclusion The results suggest that limited incision,stable fixation,fine union of fracture and fast functional recovery with interlocking intramedullary nail can be used in forearm fractures with excellent outcome,especially in the segmented and comminuted fractures.