交锁髓内钉治疗开放性胫腓骨骨折的并发症及其防治

目的观察交锁髓内钉治疗开放性胫腓骨骨折的并发症及防治。方法自2000年10月～2003年8月用交锁髓内钉共治疗开放性胫腓骨骨折58例。均采用不扩髓开放复位及静力型固定，6～8周后改动力型固定30例。结果58例均得到随访，平均16个月(6个月～2年)。愈合时间为16～40周，平均22周。伤口浅层感染5例，延期愈合8例，大隐静脉损伤2例。结论交锁髓内钉治疗开放性胫腓骨骨折的一些并发症必须引起重视，并尽力预以防治。严格掌握手术适应证和早期彻底清创是防止肢体深部感染的关键。

Prevention and management of the complications in treatment of tibiofibular open fractures with interlocking intramedullary nail

Objective To observe the complications in the treatment of open fr actures of tibia and fibula with interlocking intramedullary nail and discuss th eir prevention and management. Methods 58 patients with open fractures of tibia and fibula were treated with interlocking intramedullary nail from October 2000 to August 2003. Open reduction and static fixation with unreamed nails were appl ied in all the patients, and dynamic fixation was used in 30 patients after 6 to 8 weeks. Results Postoperative follow-ups lasted from 6 months to 2 years (ave raging 16 months). Healing time was 16 to 40 weeks (averaging 22 weeks). There w ere 5 cases of superficial infections, 8 delayed union and 2 injury of great sap henous vein. Conclusions The complications in the treatment of open fracture of tibia and fibula with interlocking intramedullary nail should draw enough attent ion of orthopedists and preventive measures be taken. The operative indications should be strictly followed and early radical debridement should be done to prev ent deep infection.