摘要
目的评价旋入式自锁髓内钉治疗四肢长骨骨折的疗效,探讨其并发症发生原因及预防方法。方法回顾性分析1994年6月至2010年12月昆明医科大学附属延安医院骨科收治的采用自制旋入式自锁髓内钉治疗且随访资料完整的415例四肢长骨骨折患者的临床资料,记录手术时间、失血量、下地负重时间和骨折愈合时间,观察并发症发生情况。结果平均手术时间50 min(15～120 min)、平均失血量100 mL(10～400 mL)、平均下地负重时间14 d(3～30 d)。415例患者获得12～60个月随访,平均随访时间18个月。骨折愈合411例(99.0%),骨折愈合时间3～10个月(平均4个月)。肢体功能评估:优328例、良80例、差7例,优良率达98.3%。4例内固定失效、3例内固定松动、4例感染、3例局部骨折、8例内固定取出困难。结论旋入式自锁髓内钉治疗四肢长骨骨折具有操作简单、创伤小、并发症少的优点,但应严格选择适应证,同时不可忽视锁片断裂、主钉取出困难等内固定相关并发症的存在。
Objective To evaluate the clinical effects of self-locking spinning insertion nail for the treatment of long bone fractures, and to explore the causes of complication and preventions. Methods From June 1994 to December 2010, 415 patients with long bone fractures were treated by self-designed rotary self-locking nails and followed up in the Affiliated Yan＇an Hospital of Kunming Medical University. Operation time, the estimate blood loss, weight-bearing time and fracture healing time were recorded, and the complications were observed and managed. Results The average operation time was 50 min（15-120 min）, the estimate blood loss was 100 mL （10-400 mL）, and the weight-bearing time was 14 d （3-30 d）. All patients were followed up from 12 to 60 months with the average of 18 months. The average fracture healing time was 4 months （3-10 months）, and 411 patients got fracture healing （99.0%）. With the evaluation of limb functions, there were excellent in 328 cases, good in 80 cases, poor in 7 cases, with the excellent and good rate was 98.3%. Complications included internal fixation failure in 4 cases, internal fixation loosening in 3 cases,infection in 4 cases, local fractures in 3 cases and difficult removal of internal fixator in 8 cases. Conclusions Treatment of self-locking spinning insertion nail for simple long bone fractures has the advantages of simple operation, minimal invasion and less complications. But it is worth noting that the indications should be chosen strictly, meanwhile the internal fixation-related complications should not be ignored such as the breakage of locking sheets, difficult nail removal and so on.
出处
《中国骨科临床与基础研究杂志》
2012年第4期263-269,共7页
Chinese Orthopaedic Journal of Clinical and Basic Research
关键词
骨折固定术
髓内
骨螺丝
四肢
Fracture fixation, intramedullary
Bone screws
Extremities
