- 期刊
The Role of an Interlocking Nail in Treatment of an Unstable Comminuted Tibial Shaft Fracture
鎖定式骨髓內釘對不穩定粉碎性脛骨幹骨折治療所佔角色
摘要
大多數脛骨幹骨折石膏固定的閉鎖式治療可得到滿意的結果。在一些情況下卻不適合做閉鎖式治療，不穩定粉碎性脛骨幹骨折癒合期會延後，以閉鎖式治療的延遲癒合率很高。因此，為避免骨折後症狀及關節僵硬，以手術治療有其應症條件。手術時不適合使用傳統內固定器材，而鎖定式骨髓內釘佔有重要性角色。從1986年12月至1989年5月，共有連續的37位病人接受Grosse-Kempf型鋼釘治療，並複查平均22個月，癒合率91.9%，癒合期5.3±2.4個月，膝部及踝關節活動也稱理想，併發症不多，包括不癒合9.1%，深部感染5.4%。螺釘很少發生斷裂或鬆脫，而且它們也不危及穩定及骨折之癒合過程。我們結論為：閉鎖式鎖定式骨髓內釘對不穩定粉碎性脛骨幹骨折佔有很重要的角色，傳統上閉鎖式治療的觀念應該被修改。
關鍵字
無資料並列摘要
Most tibial shaft fractures can be treated with closed reduction and cast immobilization. The clinical results are always satisfactory. There are some conditions which are not suitable for closed treatment. For unstable comminuted (Winquist type III, IV) tibial shaft fractures, the healing process should be makedly prolonged. It exists an indication for operative treatment to avoid fracture disease and joint stiffness. Classical internal fixators are inadequate for this treatment, and an interlocking nail stands an important role in this field. From December 1986 to May 1989, there were 37 consecutive cases treated with a Grosse-Kempf interlocking nail and followed-up for average 22 months at our hospital. The union rate was 91.9%, and union period was 5.3±2.4 months. The knee and ankle range of motions were satisfactory. The complications included: nonunion 9.1% and deep infection 5.4%. Transfix screws broke or loosened very rarely, which did no harm to the stabilization and bony healing process. Our conclusion is: closed tibial interlocking nailing furnishes a reasonable method in the treatment of a closed or mild open (Gustilo type I, II) unstable comminuted tibial shaft fracture. The traditional concept of closed treatment may be modified.
延伸閱讀
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