交锁髓内钉治疗胫骨干骨折.docVIP

交锁髓内钉治疗胫骨干骨折 【摘要】nbsp; 目的 探讨使用交锁髓内钉治疗胫骨干骨折的应用，手术方式选择及疗效。方法 对本院自2001年6月~2006年6月收治的46例胫骨骨折病人使用交锁髓内钉治疗的疗效回顾分析。手术均采用闭合、小切口切开复位的方法。从胫骨近端前进位点即胫骨平台前缘下方5~10mm置入髓内钉，用三维瞄准器锁定骨折的远端和近端。结果 46例患者平均随访12.5个月，愈合率为97.8%，平均骨性愈合6.2个月，伤肢关节功能恢复优良率95.6%。结论 交锁髓内钉是目前治疗胫骨骨折较理想的方法，术中应常规静力固定，不剥离或尽可能少剥离骨膜，与病人解释清楚，不强求解剖复位，尽量闭合复位或有限扩髓置入髓内钉。 【关键词】nbsp; 胫骨干骨折；交锁髓内钉；闭合复位；有限扩髓 nbsp;nbsp;nbsp; 【Abstract】nbsp; Objectivenbsp; lnquiry into the usage hands over to lock the pith inside nail the appliation,operation method,choice and curative effect of the shin stem bone fracture.Methodsnbsp; From June 2001-June 2006,46 shin bone fracturs usage hands over to lock the pith inside nail, the curative effct analysis,The operation all adopts to shut to match,small slice to cut open the method for reset .Near carry to go forward to order from the shin plate under 5~10mm,place into the marrow to nail ,take aim at to target the bone fracture far and near to carry with three-dimensional method.Resultsnbsp; 46 sufferer average with visit 12.5 months ,match 97.8% of rate more ,the average bone matches 6.2 months more,the broken limb joint function recovers good rate 95.6%.Conclusionnbsp; Hand over to lock the pith inside nail to cure the more ideal method of the shin bone fracture currently, in the operation should normal regulations thenbsp; fixition,dont remove or possibly little removal periosteum,explain to patient clearly,don’t demand dissect to reset,shut to match to reset as far as possible or the limited expand the pith place into the nail. nbsp;nbsp;nbsp; 【Key words】nbsp; shaft of tibia fracture;intramedullary interlock nail;shut to match to reset;the limit expands the medulla nbsp;nbsp;nbsp; 近几年来，随着社会的发展，车辆及建筑、矿山业的增加，交通事故和意外事故的增多，胫骨骨折呈明显上升趋势。较理想的治疗方法应该是能维持骨折的理想复位及固定，又能尽快恢复下肢的关节活动及负重功能。交锁髓内钉技术通过骨髓腔内插钉和胫骨近、远端螺丝钉交锁固定，能有效控制胫骨近、远端的骨干骨折重叠及旋转移位，适用于胫骨平台下7cm至踝关节面以上5cm之间的各种类型骨折［1］。本院从2001年6月~2006年6月，应用胫骨髓内钉系统治疗胫骨干骨折46例，效果优良，现报告如下。 nbsp;nbsp;nbsp; 1nbsp; 资料与方法 nbsp;nbsp;nbsp; 1.1nbs