交锁髓内钉治疗胫骨不稳定性骨折

目的 探讨交锁髓内钉治疗胫骨不稳定骨折的效果。方法 本研究38例中不扩髓法31例，扩髓法7例；闭合穿针33例，开放穿针5例；静力性固定32例，动力性固定6例。结果 平均随访时间10月（3～22月）采用Johner-Wruh评分标准，对治疗的最终结果证定：优31例，良5例，中1例，差1例。骨折平均愈合时间；闭合性骨折16周（11～24周），开放性骨折18周（12～26周），2例延迟愈合（闭合性骨折、开放性骨折各1例）。无感染及骨不连。结论 文锁髓内钉是治疗胫骨不稳定骨折的较好方法之一。

Treatment of unstable tibial fracture with interlocking intramedullary nail in 38 cases

Objective To explore the therapeutic effect of interlockingintramedullary nail for unstable tibial fracture. Methods Among 38 cases of unstable tibial fracture, including 11 open and 27 closed fracture, 31 were treated with reamed interlocking intramedullary nail and 6 with unreamed interlocking intramedullary nail. Thirty-three cases were performed with closed nailing and 5 with open nailing, and of 32 was fixed statically and 6 dynamically. Follow up for a mean duration of 10 months (3～22 months) and finally evaluated with Johner&Wruhs, criteria. Results In the assessment, the outcome was excellent in 31 cases, good in 5 cases, fair in 1 case and poor in 1 case. The time for fracture union averaged 16 weeks (11～24 weeks) in closed fracture and 18 weeks (12～26 weeks) in open fracture. Delayed union was found in 1 case of closed fracture and 1 case of open fracture. No infection and nonunion was observed in this study. Conclusion Interlocking intramedullary nail is an ideal internal fixation method to treat unstable tibial fracture.