闭合复位可膨胀自锁髓内钉治疗胫骨骨折12例效果研究

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1、闭合复位可膨胀自锁髓内钉治疗胫骨骨折12例效果研究［摘要］目的观察可膨胀自锁髓内钉(FIXIONIM)在治疗胫骨骨折中的临床效果。方法选择苏州市中医医院2010年10月〜2013年6月收治的胫骨骨折患者12例，均为AO分型中A、B型胫骨中段或中下段骨折。均采用FIXIONIM固定。观察术后愈合情况，采用Johner-Wruh标准评分评价疗效。结果12例患者均获随访5〜16个月，平均12个月。12例患者骨折均复位满意，术后切口一期愈合，骨折临床愈合时间3〜10个月,平均5个月。12例患者均未发生旋转畸形、骨折不愈合、内固定断裂再骨折、感染情

2、况，愈后膝踝关节功能正常。参照Johner-Wruh标准评定疗效，优10例，良2例。本组病例出现1例8mm短缩畸形，不影响正常行走。结论FIXIONIM系统节省扩髓和锁钉的操作，降低了手术创伤及术中出血；其轴向固定及闭合复位减少了断端骨膜剥离，增加了内固定牢度，从而缩短骨折愈合时间，并且减少了骨折不愈合、内固定断裂等并发症。［关键词］可膨胀自锁髓内钉；胫骨骨折；内固定［中图分类号］R658［文献标识码］A［文章编号］1673-7210(2013)11(c)-0078-03Effectanalysisofclosedreductionand

3、expandableintramedullarynailsfortibialshaftfracturein12patientsDUANXingxingCHENYongzhenMENGXiangqiDepartmentofOrthopedics,SuzhouHospitalofTraditionalChineseMedicine,JiangsuProvince,Suzhou215003,China[Abstract]ObjectiveToobservetheclinicaleffectofexpandableintramedullaryna

4、il(FIXIONIM)inthetreatmentoftibialfracture・Methods12patientswithtibiafracturesfromOctober2010toJune2013inSuzhouHospitalofTraditionalChineseMedicinewereselected,allofthemweremiddletibiafractureormiddle-lowertibiafractureoftypeAandB；allofthemweretreatedwithFIXIONIM.Postoper

5、ativehealingoftibiafracturewasobserve,curativeeffectwasevaluatedbybyJohner-Wruhstandardscore・Results12caseswerefollowedupfor5-16months(meantimewas12months).Satisfiedfracturereductionwasfoundin12patients，allthepostoperativeincisionwereprimaryhealing；clinicalhealingtimeoffr

6、actureswere3~10months,theaveragewere5months・Norotationaldeformity，nonunion,internalfixa.tionfractureandrefracture,infectionwasfoundamongthe12patients,kneeanklefunctionwereallnormaL10casesofexcellentcurativeeffectand2casesofgoodcurativeeffectwerefoundaccordingtotheJohner-W

7、ruhstandardscore・8mmshorteningdeformitywasfoundin1caseandtherewasnoaffecttothenormalwalking.ConclusionFIXIONIMeconomizethereamingandintramedullarynailoperation,reducetheoperationtraumaandbleedingduringoperation；theaxialfixationandclosedreductionreduceperiostealstrippingto

8、thethebrokenend,increasethefixationfastness,soitcanshortenthehealingtimeoffracture,andreducethen