非扩髓交锁髓内钉与钢板治疗胫骨干开放性骨折的疗效比较

目的:观察非扩髓交锁髓内钉治疗胫骨干开放性骨折的临床疗效。方法:胫骨干开放性骨折44例(男37例,女7例),Gustilo分类:Ⅰ型18例,Ⅱ型16例,Ⅲa型6例,Ⅲb型4例。随机分组后采用非扩髓交锁髓内钉和传统钢板方法治疗并进行疗效比较。结果:对44例进行8~22月(平均14.6月)随访,Johner-Wruh评分非扩髓交锁髓内钉组优18例,良4例,差1例,优良率95.7%,总感染率为9.5%,所有病例无髓内钉及锁钉断裂等情况出现,骨折平均愈合时间为27.4±4.9 w。钢板组优11例,良7例,差3例,优良率85.7%,总感染率为14.3%,所有病例无钢板螺钉断裂等情况出现,骨折平均愈合时间为30.3±6.5 w。结论:非扩髓交锁髓内钉在治疗胫骨干开放性骨折中,疗效显著,是一种较为理想的内固定方法。

Effect of Nonreaming Interlocking Nailing on Treating Open Tibial Shaft Fractures

Objective To observe the clinical effect of nonreaming inter locking nailing on treating open tibial shaft fractures. Methods 44 cases(male 37cases;female 7cases) of open tibial shaft fractures were classified according to the Gustilo methods:18 belonged to typeⅠ,16 belonged to typeⅡ,6 belonged to typeⅢa,16 belonged to typeⅢb.All cases were randomizated two groupes,one group was treated nonreaming inter locking nailing and the other was traditional nickelclad.Results Among the 44 cases which were followed up ranging from 8～22 months(meantime 14.6 months).According to the criteria of Johner-wruth,18 cases were excellent,4 cases were good,1 case was poor,the fine rate is 95.7%,the infection rate is 9.5%,the average cure time is 27.4±4.9 weeks in the nonreaming inter locking nailing group.11 cases were excellent,7 cases were good,3 cases were poor,fine rate is 85.7%,the infection rate is 14.3%,the average cure time is 30.3±6.5 weeks in the nickelclad group.All cases were not broken in nails and nickelclad and screws.Conclusion The curative effect of nonreaming inter locking nailing on treating open tibial shaft fractures is excellent and the method deserves to applicate in clinic.