带锁髓内钉固定治疗胫骨干骨折的术后并发症观察

目的探讨带锁髓内钉治疗胫骨干骨折的术后并发症。方法回顾性分析自1996年4月-2008年6月胫骨干骨折118例及26例胫骨骨不连的患者,骨折患者采用闭合复位、有限切口切开复位,带锁髓内钉静力型固定。骨不连患者采用切开复位,带锁髓内钉静力型固定并植骨。结果 122例获得随访,随访13-29个月（平均17.7个月）,24例患者出现明显的并发症,其中,骨不连10例,骨折端分离4例,膝关节疼痛3例,成角畸形3例,深部感染2例,主钉断裂1例,锁钉退出1例。结论带锁髓内钉治疗胫骨干骨折有较高的并发症发生率,骨折端存在明显间隙者有较高的骨不连发生率。

To study of the treatment of comminuted fracture of tibia shaft with interlocking intramedullary nailing and bone grafting

Objective To study the postoperative complications of tibia shaft fracture with interlocking intramedullary nailing.Methods Since from April 1996 to June 2008,144 cases of tibia shaft fracture（118 cases of tibia shaft fracture and 26 cases delayed unions or nonunions） were manipulated to anatomic replacement by closed and a limited open reduction and static fixation with intramedullary interlocking nails.nonunions were treated with open nailing with bone grafting.Results 122 cases were followed-up from 13 months to 29 months（average 17.7 months）,24 cases achieved significant complications.10 of them were persistent nonunions.4 cases of fracture gao,3 cases of knee pain,3 cases of angular malunion,2 cases of deep infection,1 cases of nail broken,1 cases of locking screw drop out.Conclusion The risk of operative comminution was significantly higher in intramedullary nailing,and operative comminution resulted in a significantly higher risk of nonunions.