闭合复位可膨胀自锁髓内钉治疗胫骨骨折12例效果分析

目的 观察可膨胀自锁髓内钉（FIXION IM）在治疗胫骨骨折中的临床效果.方法 选择苏州市中医医院2010年10月～2013年6月收治的胫骨骨折患者12例,均为AO分型中A、B型胫骨中段或中下段骨折.均采用FIXION IM固定.观察术后愈合情况,采用Johner-Wruh标准评分评价疗效.结果 12例患者均获随访5～16个月,平均12个月.12例患者骨折均复位满意,术后切口一期愈合,骨折临床愈合时间3～10个月,平均5个月.12例患者均未发生旋转畸形、骨折不愈合、内固定断裂再骨折、感染情况,愈后膝踝关节功能正常.参照Johner-Wruh标准评定疗效,优10例,良2例.本组病例出现1例8 mm短缩畸形,不影响正常行走.结论 FIXION IM系统节省扩髓和锁钉的操作,降低了手术创伤及术中出血;其轴向固定及闭合复位减少了断端骨膜剥离,增加了内固定牢度,从而缩短骨折愈合时间,并且减少了骨折不愈合、内固定断裂等并发症.

Effect analysis of closed reduction and expandable intramedullary nails for tibial shaft fracture in 12 patients

Objective To observe the clinical effect of expandable intramedullary nail （FIXION IM） in the treatment of tibial fracture.Methods 12 patients with tibia fractures from October 2010 to June 2013 in Suzhou Hospital of Traditional Chinese Medicine were selected,all of them were middle tibia fracture or middle-lower tibia fracture of type A and B; all of them were treated with FIXION IM.Postoperative healing of tibia fracture was observe,curative effect was evaluated by by Johner-Wruh standard score.Results 12 cases were followed up for 5-16 months （mean time was12 months）.Satisfied fracture reduction was found in 12 patients,all the postoperative incision were primary healing; clinical healing time of fractures were 3-10 months,the average were 5 months.No rotational deformity,nonunion,internal fixation fracture and refracture,infection was found among the 12 patients,knee ankle function were all normal.10 cases of excellent curative effect and 2 cases of good curative effect were found according to the Johner-Wruh standard score.8 mm shortening deformity was found in 1 case and there was no affect to the normal walking.Conclusion FIXION IM economize the reaming and intramedullary nail operation,reduce the operation trauma and bleeding during operation; the axial fixation and closed reduction reduce periosteal stripping to the the broken end,increase the fixation fastness,so it can shorten the healing time of fracture,and reduce the nonunion of fracture,internal fixation of fracture and other complications.