Purpose:Distal tibia fractures comprise about 7%-10% of lower extremity trauma.Because of the peculiarity of the soft tissue and subcutaneous location of the bone there are many controversies in the ideal treatment of...Purpose:Distal tibia fractures comprise about 7%-10% of lower extremity trauma.Because of the peculiarity of the soft tissue and subcutaneous location of the bone there are many controversies in the ideal treatment of distal tibia fractures especially extra articular pilon fractures.Plating is fraught with complications of wound dehiscence and infection.There are limited studies which document outcomes in such cases using intramedullary interlocking nail.We intend to study the outcome and complications of extra articular distal tibial fractures treated with interlocking nailing.Methods:This is a prospective study conducted in a tertiary care orthopaedic hospital in southern India.There are 147 patients of distal tibia extra-articular fractures managed by IM nailing with follow up of more than one year were included in this study.Only cases with fresh injury (less than 1 week),fracture below the isthmus,closed and open Gustilo Anderson type 1 and 2 fractures were included in the study.Patients were reviewed at 3,6,12 and 24 weeks after surgery and thereafter at one year and were assessed for clinical and radiological signs of healing,any complications,time to union and functional outcome.Results:There were 102 males and 45 females (male/female ratio is 2.3∶1) with a mean age of 38.96 (range 23-65) years.According to AO classification,there were 78 cases (53.06%) of 43-A1,39 cases (26.53%) of 43-A2 and 30 cases of 43-A3 constituting 20.40%.The fracture united in all the patients at an average of 18 weeks (range 16-22 weeks),none of the patient in our series had a delayed or non-union.Two patients (1.47%) had the fracture united in mild valgus but it was well within the acceptable limits (<5°).The functional outcome was assessed in all the patients at final follow up using Olerud and Molander score all the patients fared an excellent to good score,there were no cases with poor score.Conclusion:Intramedullary nailing is a viable option to treat distal tibial fractures with excellent outcome.Wound complications rel展开更多
目的探讨双克氏针经基底髓内交叉固定治疗近节指骨关节外骨折的效果。方法回顾性分析2016年5月—2018年5月哈尔滨市第五医院骨科收治的22例(23指)近节指骨关节外骨折患者,男性18例,女性4例;年龄18~50岁,平均35.4岁。致伤原因:摔伤5例,...目的探讨双克氏针经基底髓内交叉固定治疗近节指骨关节外骨折的效果。方法回顾性分析2016年5月—2018年5月哈尔滨市第五医院骨科收治的22例(23指)近节指骨关节外骨折患者,男性18例,女性4例;年龄18~50岁,平均35.4岁。致伤原因:摔伤5例,暴力扭伤5例,压砸伤4例,击打伤8例。伤指分布:示指9指,中指6指,环指3指,小指5指。伤后至手术时间1~4d,平均2.3d。均臂丛麻醉下行闭合复位双克氏针经基底交叉固定治疗,术后复查手指正侧位X线片,术后第2天在专业康复师指导下开始功能练习,术后每4周复查手指正侧位X线片。统计分析手术时间、骨折愈合时间、患指掌指关节活动度,患指屈伸活动按照手指总主动活动度(total active motion,TAM)评价。结果手术时间30~42min,平均38.6min;术后无针道感染、克氏针变形、断裂发生。患者均获4~9个月门诊随访,平均5.7个月;骨折临床愈合时间(8.95±3.38)周;拔除克氏针后1周,患指掌指关节活动度为81°~89°,平均87.5°;TAM为243°~278°,平均265.4°,均为优。结论采用闭合复位双克氏针经基底髓内交叉固定治疗近节指骨关节外闭合骨折,手术操作简单、损伤小、固定可靠,患指可早期功能练习,预后好。展开更多
文摘Purpose:Distal tibia fractures comprise about 7%-10% of lower extremity trauma.Because of the peculiarity of the soft tissue and subcutaneous location of the bone there are many controversies in the ideal treatment of distal tibia fractures especially extra articular pilon fractures.Plating is fraught with complications of wound dehiscence and infection.There are limited studies which document outcomes in such cases using intramedullary interlocking nail.We intend to study the outcome and complications of extra articular distal tibial fractures treated with interlocking nailing.Methods:This is a prospective study conducted in a tertiary care orthopaedic hospital in southern India.There are 147 patients of distal tibia extra-articular fractures managed by IM nailing with follow up of more than one year were included in this study.Only cases with fresh injury (less than 1 week),fracture below the isthmus,closed and open Gustilo Anderson type 1 and 2 fractures were included in the study.Patients were reviewed at 3,6,12 and 24 weeks after surgery and thereafter at one year and were assessed for clinical and radiological signs of healing,any complications,time to union and functional outcome.Results:There were 102 males and 45 females (male/female ratio is 2.3∶1) with a mean age of 38.96 (range 23-65) years.According to AO classification,there were 78 cases (53.06%) of 43-A1,39 cases (26.53%) of 43-A2 and 30 cases of 43-A3 constituting 20.40%.The fracture united in all the patients at an average of 18 weeks (range 16-22 weeks),none of the patient in our series had a delayed or non-union.Two patients (1.47%) had the fracture united in mild valgus but it was well within the acceptable limits (<5°).The functional outcome was assessed in all the patients at final follow up using Olerud and Molander score all the patients fared an excellent to good score,there were no cases with poor score.Conclusion:Intramedullary nailing is a viable option to treat distal tibial fractures with excellent outcome.Wound complications rel
文摘目的探讨双克氏针经基底髓内交叉固定治疗近节指骨关节外骨折的效果。方法回顾性分析2016年5月—2018年5月哈尔滨市第五医院骨科收治的22例(23指)近节指骨关节外骨折患者,男性18例,女性4例;年龄18~50岁,平均35.4岁。致伤原因:摔伤5例,暴力扭伤5例,压砸伤4例,击打伤8例。伤指分布:示指9指,中指6指,环指3指,小指5指。伤后至手术时间1~4d,平均2.3d。均臂丛麻醉下行闭合复位双克氏针经基底交叉固定治疗,术后复查手指正侧位X线片,术后第2天在专业康复师指导下开始功能练习,术后每4周复查手指正侧位X线片。统计分析手术时间、骨折愈合时间、患指掌指关节活动度,患指屈伸活动按照手指总主动活动度(total active motion,TAM)评价。结果手术时间30~42min,平均38.6min;术后无针道感染、克氏针变形、断裂发生。患者均获4~9个月门诊随访,平均5.7个月;骨折临床愈合时间(8.95±3.38)周;拔除克氏针后1周,患指掌指关节活动度为81°~89°,平均87.5°;TAM为243°~278°,平均265.4°,均为优。结论采用闭合复位双克氏针经基底髓内交叉固定治疗近节指骨关节外闭合骨折,手术操作简单、损伤小、固定可靠,患指可早期功能练习,预后好。
