矩形髓内钉与Ender钉治疗胫腓骨骨折的临床应用比较

目的：比较矩形髓内钉与Ｅｎｄｅｒ 钉的临床疗效，为弹性固定的进一步发展提供临床依据。方法：１９９３ ～１９９７ 年，采用矩形髓内钉（ ＲＩＮ） 与Ｅｎｄｅｒ 钉内固定治疗胫腓骨骨折共２１８ 例，比较２ 组内固定的术中指标如手术时间、术中出血量、插钉操作＞ ２ 次率、窗口劈裂率、钉端异位穿出率及术后指标，包括：石膏固定时间、部分负重下地时间、骨痂开始生长时间、骨折愈合时间、成角畸形率及二次手术率等，并进行统计学处理。结果：ＲＩＮ 钉的术中各项指标值均小于Ｅｎｄｅｒ 钉，有统计学意义（ Ｐ＜ ０－０１） ；而２ 者对骨愈合的影响无显著差异（ Ｐ＞ ０－０１） ；２ 种钉内固定后的侧方成角畸形率相当，但ＲＩＮ 钉的前、后及旋转畸形发生率较Ｅｎｄｅｒ 钉小（ Ｐ＜ ０－０１） ，二次手术率亦小于Ｅｎｄｅｒ 钉（ Ｐ＜ ０－０１） 。结论：ＲＩＮ 钉在手术操作、术中损伤及固定强度方面，优于Ｅｎｄｅｒ 钉，但两者对骨折愈合时间的影响无差别。

Clinical Com parison of Internal Fixation of Tibio fibular Fracture :Rectangle shaped Intra medullary Nails versus Ender's Nails

Objective :The clinical effect of two types of co m m only used flexible nails ,w hich is rectangle shaped intra medul lay nail ( RIN)and Ender's nail ,were retrospectively co mpared ,the results can be useful for flexible internal fixation design . Methods :218 cases of tibio fibular fracture patients w hich were treated by Ender's or RIN nail were reviewed ,and following da ta were co mpared statistically :one is the data collected during operation including operative time ,a mount of bleeding ,nailinsert ing times m ore than 2 times ,fracture of nail entry ,and pentration of nailend ,etc .Another group of data collected after operation including time of externalim m obilization by plaster ,tim e of partial weight bearing walk ,time of bone callus form ation ,time of bone union ,deformity rate and rate of reoperation .Results :Data during operation showed that operative tim e ,a mount of bleed ing ,nailinserting times more than 2 times ,fracture of nail entry ,and penetration of nail end ,etc of RIN was significantly less than those of Ender's nail( P< 0-01) ,but there was no significance in the effect to bone union .Lateral deformity rate of RIN and Ender's nail were the sa me ,w hile the anter posterior deformity and rotational deformity ,as well as the reoperative rate due to deformity waslessthan Ender's nail( P< 0-01) .Conclusion :The RIN was m ore simple and less dam age during operation ,and has greater stability com pairing to Ender's nail,and they have the sa me affection on fracture healing .