摘要
目的 分析交锁髓内钉治疗长骨骨折并发症的原因 ,并提出具体防治措施。 方法自 1998年 1月至 2 0 0 0年 5月共用交锁髓内钉治疗长骨骨折 16 8例 ,其中股骨 77例 ,胫骨 6 7例 ,肱骨 2 4例。 结果 全部病例经 5～ 2 4个月随访 ,共发生各种并发症 14例 (8.33% ) ,其中感染 4例 ,肢体坏死 1例 ,适应证选择不当造成内固定失败 2例 ,术中再骨折 2例 ,远端锁钉放置失败 2例 ,髓钉进入关节 1例 ,锁钉断钉 1例 ,退钉 1例。 结论 交锁髓内钉治疗长骨骨折应注意以下几点 :(1)严格掌握适应证 ;(2 )严格操作规程 ,提倡闭合穿钉 ;(3)重建骨的连续性 ,适当延迟负重时间 ;(4 )术中在C形臂X线机监视下操作。
Objective To analyze the cause for complications of the long bone fractures treated with the interlocking nail and indicate the prevention and treatment measures. Methods From January 1998 to May 2000,168 patients with long bone fractures were treated with the interlocking nail. Of them, there were 77 cases of femoral fractures, 67 tibial fractures and 24 humeral fractures. Results All patients were followed up for 5-24 months. Complications occurred in 14 cases (8.33%) including 4 cases of infections, 1 lower limb necrosis, 2 internal fixation failure due to incorrect indication, 2 re-fractures during the operation, 2 distal screw misinserted,1 nail into the ankle joint, 1 distal screw broken and 1 distal screw loosening. Conclusions We should attach great importance to the following points during treatment of long bone fractures with interlocking nail:(1) The indications must be correctly handled. (2) The technique for interlocking nail must be performed strictly during operation; close inserting nail is proposed.(3) As for the comminuted fractures, bone continuity should be reconstructed and the time to start weight bearing properly delayed. (4) C-Arm X-ray supervision is necessary during operation.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2003年第6期352-355,共4页
Chinese Journal of Trauma
关键词
交锁髓内钉
长骨骨折
并发症
内固定
预后
X线检查
Femoral fractures
Tibial fractures
Humeral fractures
Fracture fixation, intramedullary
