摘要
目的 探讨交锁髓内钉治疗股骨干骨折术后并发症的原因 ,并提出防治措施。 方法 对我院 1994～ 1999年 116例交锁髓内钉治疗股骨干骨折病人进行回顾分析 ,其中对 14例延迟愈合者采取拔除锁钉 ,变静力固定为动力固定 ;对 6例骨不连者 ,全部取钉、换钉并植骨 ;对 4例骨感染者进行病灶清除加拔钉 ,适度的外固定。 结果 骨延迟愈合 14例 ,随访 1年全部愈合 ;骨不连 6例 ,其中二次手术 4例 ,三次手术 2例 ,随访 1年半均愈合 ;骨感染 4例 ,3例愈合 ,1例未愈。总有效率 95 .8%。 结论 交锁髓内钉治疗股骨干骨折 ,虽比其他内固定具有较明显的优势 ,但产生骨延迟愈合、骨不连、骨感染、断钉等并发症并不少见。严格掌握手术指征、适当选材、适时掌握静力固定与动力固定、第二次手术扩髓与不扩髓、彻底清创与严格的无菌操作是减少并发症的有效措施。
Objective To investigate the causes and preventive methods of postoperative complications of femoral shaft fracture treated with intramedullary interlocking nails. Methods A total of 116 patients with femoral shaft fractures admitted to our hospital from 1994 to 1999 were retrospectively studied in this article. They were all treated with intramedullary interlocking nails. The locking nails were removed from the 14 patients with delayed union to convert the fixation from static to dynamic. For the 6 patients with bone nonunion, the locking nails were removed, and new locking nails and bone grafts were employed. And for the 4 patients with bone infection, the foci were cleaned and the locking nails were removed, then certain external fixation was applied. Results Followed up for 1 year, the fractures of 14 patients with delayed union were completely healed. For the 6 patients with bone nonunion, reoperation was needed in 4 patients and a third operation needed in 2 patients, and they all healed after being followed up for one and half a year. For the 4 patients with bone infection, only 3 patients healed. The whole effective rate was 95.8%. Conclusions Although the intramedullary interlocking nails used for femoral shaft fractures have advantages than other internal fixations, the complications of delayed healing, nonunion, bone infection and breaking nails are often found. The effective measures to reduce the complications include strict master of the operative indications, suitable materials for the implant and conversion of the fixation from static to dynamic in time, careful selection of debriding the realm or debriding no realm, complete debridement and strict abacterial procedures.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2001年第5期290-292,共3页
Chinese Journal of Trauma
关键词
股骨干骨折
交锁髓内钉
骨折固定术
并发症
Femoral fractures
Postoperative complications
Fracture fixation, intramedullary
Intramedullary interlocking nails
