带锁髓内钉治疗胫骨骨折（附33例报告）

作者总结了33例均采用带锁髓内钉内固定的不同类型的胫骨骨折，其中扩髓16例，不扩髓17例闭合骨折22例，开放骨折11例，除6例失访外，其余27例平均随访时间17．9个月（4－31个月），22例在半年内愈合，1例延迟愈合，1例远端锁钉断钉，3例随访时间不足半年，闭合骨折从致伤到手术平均时间为3．55天（入院当天－27天），开放骨折均在当天手术。闭合骨折扩髓12例，占54．5％（12／22）；开放骨扩扩髓4例，占36．3％（4／11），术后均未发生骨筋膜室综合征或感染。提示带锁髓内钉适用于治疗胫骨骨折，非扩髓带锁髓内钉适于开放骨折和多发伤，早期手术并不影响预后，且可减少并发症。

TIBIAL FRACTURES TREATED WITH INTERLOCKING INTRAMEDULLARY PIN (REPORT OF 33 PATIENTS)

Thirty three tibial fractures treated with interlocking intramedullary nail(IMN) were reviewed. Of all the patients, 16 were fixed with reamed IMN, and 17 with nonreamed IMN. There were 22 closed and 11 open fractures. Twenty seven patients were followed up for an average of 17.9 months (4 to 31 months). Of all the patients, 22 healed in 6 months, delayed healing occurred in 1,and in 1 the distal locking screw was broken. In the close fractures, the mean time from fracture to operation was 3.55 days (from the injury day to 27 days) , and in the open fractures operation was all done on the day of injury. Nonreamed IMN was used in 12 closed fractures (54.5%, 12/22 ) , and reamed IMN was used in 4 open fractures (36.3%, 4/11). There was no postoperative compartment syndrome or infection. The interlocking intramedullary pin is indicated for the tibia fractures, and early operation is feasible . The nonreamed interlocking intramedullary pin is suitable for open fractures and multi injuries.