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首页> 外文期刊>Journal of Advances in Medical and Pharmaceutical Sciences >Intramedullary Interlocking Nailing for Long Bone Fractures of the Lower Limbs: Our Experience with Free-hand Locking
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Intramedullary Interlocking Nailing for Long Bone Fractures of the Lower Limbs: Our Experience with Free-hand Locking

机译:下肢长骨骨折的髓内锁定钉:我们徒手锁定的经验

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Aims: To see the pattern of interlocking nailing used for fractures of lower limb’s long bones in terms of the bone affected, laterality, age distribution, sex distribution, pattern of locking and early outcome. Study Design: The study is a retrospective cross sectional study conducted over three years from April 2013 to march 2016 in a private hospital in Kano, North western Nigeria. Methodology: All patients that had intramedullary nailing for femoral and/or tibial fractures within the period of study, were recruited. Theatre register was used to extract the file numbers of the patients. The folders were retrieved and the information extracted. The Data was analysed using XLStat software. Results: The age ranges from 19 -70 years with a majority between 20-39 years. There is only one person below the age of twenty and is in the male category. There were a total of 87 procedures conducted on 81 patients of which 70(86.4%) were males and 11(13.6%) were females. Only 77% of the interlocking nail were locked at both ends, the remaining were locked at one end with the other end abandoned due to difficulty in getting the hole or actually not attempted. Of the 87 nailings, 5 were inappropriately locked outside by the side of the distal nail and 2 were locked distal to the tip of the nail. One femoral and 3 tibial, developed non-union requiring exchange nailing with a larger diameter nail and cancellous bone graft. 6 patients developed surgical site infection which were manage successfully with antibiotics and wound care with only 2 tibial nails requiring conversion to external fixation using Linear Rail system for compression. 70(86%) of the patient were satisfied with their treatment with very good – excellent range of motion, while 11(14%) patient have either of reduce range of motion, anterior knee pain or abnormal gait. Conclusion: Most challenging aspect of the procedure were intraoperative radiography was not available, is correct placement of the distal locking screws. Use of a distal targeting device is the main stay, while using the guide wire to sound the drill bit/screw increases the chances of accurate placement.
机译:目的:从患骨,侧面,年龄分布,性别分布,锁定模式和早期结果等方面,了解用于下肢长骨骨折的互锁钉模式。研究设计:该研究是一项回顾性横断面研究,从2013年4月至2016年3月,在尼日利亚西北部卡诺的一家私立医院进行了三年。方法:招募了研究期间所有因股骨和/或胫骨骨折而进行髓内钉治疗的患者。使用剧院登记簿提取患者的档案编号。检索文件夹并提取信息。使用XLStat软件分析数据。结果:年龄范围为19 -70岁,大多数介于20-39岁之间。只有一个20岁以下的人属于男性。共对81例患者进行了87项手术,其中男性70例(86.4%),女性11例(13.6%)。互锁钉子只有77%的两端都被锁住了,其余的锁在一端,而另一端则由于难以打孔或实际上没有尝试而被放弃。在87个钉子中,有5个被不适当地锁定在远端钉子的外侧,另外2个被锁定在钉子尖端的远端。 1个股骨和3个胫骨发达的不愈合,需要用较大直径的钉子和松质骨移植物进行置换钉子。 6例发生手术部位感染的患者仅用2根胫骨钉成功治愈,并需使用抗生素和伤口护理,这些钉需要使用Linear Rail系统进行加压以转换为外固定。 70%(86%)的患者对自己的治疗效果非常满意–动作范围出色,而11(14%)的患者则出现了动作范围缩小,膝前疼痛或步态异常。结论:手术中最具挑战性的方面是术中X线检查不可行,远端锁定螺钉的正确放置。主要目的是使用远端定位设备,而使用导丝使钻头/螺钉发声则增加了准确放置的机会。

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