借助自制导丝器和带锁髓内钉治疗胫骨多段骨折

摘要

目的 介绍应用有限切开借助自制导丝器导入钢丝环扎辅助和带锁髓内钉治疗胫骨多段骨折的实践经验.方法 有限切开用自制导丝器导入钢丝环扎做为辅助和带锁髓内钉中心性低占位性固定治疗37例胫骨多段骨折.结果 随访9～18个月,平均随访12.67个月,骨折在11～48周愈合,平均愈合时间为16.27周,按Johner功能评价标准,优33例,良2例,差2例,优良率94.60%,1例延迟愈合,2例软组织感染骨外露.结论 带锁髓内钉复合自制导丝器导入钢丝行环扎治疗胫骨多段骨折,能显著增加固定的稳定性,大大缩短了骨折愈合时间,且创伤小,操作简便.%Objective To introduce a practical experience of treatment of multisegment tibia fracture with assitance of self-made wire-guiding instrument and inter-locking intramedullary nail to make limited insicion. Method Make a limi-ted insicion followed by wire 360 °ligation with assistance of self-made wire-guiding instrument and interlocking intra-medullary nail fixation to treat 37 cases of multisegment tibia fractures. Result The follow up time was 9 ～ 18 months (mean 12.67 months). The duration of fracture union was 11 ～ 48 weeks(mean 163.27 weeks).According to Johner cri-teria,good cases were 33,fair cases were 2 and bad cases were 2. The good and fair results were 94.60%. One patient ob-tained delayed union and 2 patients got bone exposure due to soft tissue infection. Conclusion Treatment of multisegment fracture of tibia with self-made wire-guiding instrument and inter-locking intramedullary nail can obviously enhance the stability of facture fixation thus greatly shorten the fracture union time. In additon,the trauma of this method is minimal and the procedure is simple.