带锁髓内钉治疗胫骨骨折失误原因分析

目的 分析带锁髓内钉治疗胫骨干骨折临床应用失误产生的原因并提出预防措施.方法 2002年2月对87例（92侧胫骨）采用带锁髓内钉治疗,男62例,女25例.开放性骨折7例,闭合性骨折80例,伴有腓骨骨折68例,骨折距上、下胫腓联合7 cm内,作相应内固处理.结果 所有患者随访6～24个月,平均11个月,出现并发症9例,其中胫骨上段后侧劈裂1例,骨折远近端骨质劈裂1例,远端锁钉放置失败2例,脂肪栓塞综合征1例,伤口感染1例,腓总神经损伤1例,肢体短缩1例,远端锁钉退出1例.结论 术者只要熟悉人体解剖结构,正确应用带锁髓内钉器械,完全可以避免这些并发症的发生.

Treatment with intramedullary nails tibial fracture reason analysis turnovers

Objective To study the complications and prevention methods in the treatment of tibial fracture with interlocking intrameduary nail. Methods February 2002 87cases （92 tibias） with interlocking interameduUary,62 male and 25 females. 7 cases of open fracture,closed fracture in 80,68 with fibula,t he intenal fixation treatment were performed in 7 cm of superior and inferior tibiofibular joint. Results All the patients were followed up from 6 months to 24 months. 9 patients had complications. 1 case rupture at superoposterior tibial, 1 case rupture at tibial fracture end, 2cases failure to lock with bolt, 1 case fat emboish syndrome, 1 case incision infectiom, 1 case common peromea nerve injury, 1 case calf shortening, 1 case distal bolt screwed out. Contusion It is important to know anatomy of tibia well and use correctly the instrument of interlocking intramedullary nail for the prevention of the complications.