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旋转臂自锁式髓内钉置入治疗胫骨骨折29例
引用本文:赵卫,张继荣. 旋转臂自锁式髓内钉置入治疗胫骨骨折29例[J]. 中国临床康复, 2011, 0(30): 5684-5688
作者姓名:赵卫  张继荣
作者单位:贵州省黔西南州医院骨一科,贵州省兴义市562400
摘    要:背景:由于胫骨解剖的特殊性,骨折后治疗方法较多并各有优缺点。目的:观察旋转臂自锁式髓内钉置入内固定治疗胫骨骨折的临床效果。方法:选择贵州省黔西南州医院骨一科收治的胫骨骨折患者29例,其中闭合性骨折26例,开放性骨折3例(均为GustiloⅠ型),均采用旋转臂自锁式髓内钉置入内固定治疗。以X射线平片观察骨折愈合及并发症发生情况。结果与结论:29例患者均获得随访,随访时间12~24个月,治疗后切口均获Ⅰ期愈合,髓内钉置入内固定后6~18个月复查X射线片,骨折线消失,骨痂生长良好。未发生切口感染、创伤性滑膜炎、髓内钉松动及骨不愈合,膝踝关节伸屈功能及行走正常。根据Johner-Wruh功能评定标准,优11例,良16例,中2例,优良率为93.3%。提示旋转臂自锁式髓内钉具有内固定牢靠、操作简单、骨折愈合率高等优点,是治疗胫骨骨折比较理想的方法。

关 键 词:自锁髓内钉  胫骨骨折  内固定  X射线  骨折愈合

Rotating-arm self-locking intramedullary nail for tibial fractures in 29 cases
Zhao Wei,Zhang Ji-rong. Rotating-arm self-locking intramedullary nail for tibial fractures in 29 cases[J]. Chinese Journal of Clinical Rehabilitation, 2011, 0(30): 5684-5688
Authors:Zhao Wei  Zhang Ji-rong
Affiliation:( Department of Orthopedics,Qianxinan Orthopedic Hospital of Guizhou Province,Xingyi 562400,Guizhou Province,China )
Abstract:BACKGROUND:Because of the special nature of anatomical tibial,there are many therapies after fractures and each has its own advantages and disadvantages. There is no an ideal method of internal fixation. OBJECTIVE:To study the clinical efficacy of rotating arm self-locking intramedullary nail(RSIN) fixation on tibial fractures. METHODS:Twenty-nine patients with tibial fractures were selected from Qianxinan Orthopedic Hospital of Guizhou Province,including 26 cases of closed fracture,and 3 cases of open fracture(all GustiloI type) . RSIN fixation was used. X-ray observation was performed for fracture healing and complications. RESULTS AND CONCLUSION:All the 29 patients were followed up for 12-24 months. Incision healing reached to phase Ⅰ. After 6 to 18 months,X-ray film showed that fracture line disappeared,callus grew well. Complications such as wound infection,traumatic synovitis,nail loose and nonunion did not occur after surgery. Knee-ankle-joint flexion and extension function and walking were normal. According to Johnr-Wruh standard,among the 29 cases,11 cases were excellent,16 cases were good,and 2 cases were middle and the good rate was 93.3%. The results suggest that RSIN fixation is reliable,simple to operate,and has a high rate of fracture healing,which is the ideal method to treat tibial fractures.
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