胫骨中远1/3骨折应用交锁髓内钉治疗时腓骨骨折不予固定的临床观察

目的探讨胫骨中远1/3骨折应用交锁髓内钉治疗时同水平腓骨骨折不予固定的临床治疗。方法回顾性分析唐山市第二医院创伤骨科2014年5月-2017年7月胫腓骨中远1/3骨折患者34例,男性21例,女性13例;年龄19~63岁,平均40.5岁,均采用胫骨骨折交锁髓内钉固定,腓骨骨折不予固定。术后采用美国足与踝关节协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝与后足评分评价踝关节情况。结果 34例患者术后均获得随访,随访时间12~24个月,平均13.6个月。患者均获得骨性愈合,骨折愈合时间为2~3个月,平均2.4个月。术后12个月随访无骨髓炎、骨折不愈合、畸形愈合、内固定断裂失效等病例。AOFAS踝与后足评分,评分84~96分,平均91.5分;其中优28例,良6例。结论胫骨中远1/3骨折应用交锁髓内钉治疗,腓骨骨折不予固定时患者胫腓骨骨折愈合率高,无胫骨骨折不愈合及畸形愈合发生。

Clinical analysis of distal third tibia-fibula fractures treated by tibia intramedullary nail without fibular fixation

Objective To explore the clinical experience and outcomes of intramedullary nailing of the distal 1/3 tibia-fibula fracture without fibular fixation. Methods A retrospective analysis on 34 patients with distal 1/3 tibia-fibula fractures from May 2014 to Jul. 2017 was carried out. There were 21 males and 13 females aged from 19 to 63(mean age,40.5) years. All patients were treated with intramedullary nailing for the distal 1/3 tibia fractures without fibular fixation. The American Orthopaedic Foot and Ankle Society(AOFAS) score was used to evaluate the ankle condition. Results All of the 34 patients were followed up after operation from 12 months to 24 months(on average of 13.6 months). All patients obtained good fracture union.The mean time of the fracture union was 2.4 months(range,2-3 months). No osteomyelitis,non-unions,malunions or metal failure occurred till follow-up of 12 months. The AOFAS score was 91. 5(range,84-96),in which 28 cases were good,6 cases were fair. Conclusion The treatment of intramedullary nailing of the distal 1/3 tibia-fibula fractures without fibular fixation is effective. It could obtain good reduction,reliable fixation,few complications and high fracture union rates without nonunion and malunion.