CAJ | 학술논문

目的探讨利用扩髓技术，应用传统交锁髓内钉及解剖型胫骨钉治疗胫骨中远段开放性骨折的疗效。方法回顾本院2008年5月至2011年5月行交锁髓内钉内固定手术的36例胫骨中远段开放性骨折病例。均使用扩髓技术。其中男21例，女15例，年龄20～65岁。左侧为15例，右侧为21例，合并腓骨骨折12例，胫骨多段骨折为6例，均未累及远端负重关节面。按AO/ASIF分类，42A型10例，42B型12例，42C型6例，43A型8例。按Gustilo分型，为I型16例，II型20例。结果术后随访6-18个月，其中1例术后超过14个月未愈合，余均取得良好的临床疗效。无骨折畸形愈合，无术后感染，锁钉未发现断钉现象。骨折平均愈合时间18周。结论应用传统胫骨交锁髓内钉及解剖型胫骨钉治疗胫骨中远段开放性骨折骨折，使用扩髓技术，符合骨折内固定要求，扩髓未增加感染风险，效果理想。
목적탐토이용확수기술，응용전통교쇄수내정급해부형경골정치료경골중원단개방성골절적료효。방법회고본원2008년5월지2011년5월행교쇄수내정내고정수술적36례경골중원단개방성골절병례。균사용확수기술。기중남21례，녀15례，년령20～65세。좌측위15례，우측위21례，합병비골골절12례，경골다단골절위6례，균미루급원단부중관절면。안AO/ASIF분류，42A형10례，42B형12례，42C형6례，43A형8례。안Gustilo분형，위I형16례，II형20례。결과술후수방6-18개월，기중1례술후초과14개월미유합，여균취득량호적림상료효。무골절기형유합，무술후감염，쇄정미발현단정현상。골절평균유합시간18주。결론응용전통경골교쇄수내정급해부형경골정치료경골중원단개방성골절골절，사용확수기술，부합골절내고정요구，확수미증가감염풍험，효과이상。
Objective To explore clinical outcome of the treatment on open tibial middle and distal segment fractures of interlocking intramedullary nails and anatomical type tibial nails by using of reamed technology.Methods A retrospective review of 36 patients suffering tibial distal segment of open fractures accepting interlocking intramedullary nail fixation from May 2008 to May 2011 in our hospital. Reamed technology was uesd for all patients . There were 21 males and 15 females, aged 20-65 years old. 15 cases were suffering left side, the right side is 21 cases.12 cases were with fibula fractures, and 6 patients were tibia multiple fractures, All of them did not involve the far end load articular surface. According to the AO/ASIF classification, 42A type was 10 cases,42B 12 cases, 42C 6 cases, and 43A 8 cases. According to the Gustilo classification, 16 cases of type I and 20 type II. Results Cases were followed up for 6 to 18 months, 1 case did not heal after14 months , others had achieved good clinical curative effect.All cases had no fracture malunion, no postoperative infection, No broken locking screws. Average healing time 18 weeks. Conclusion Application of traditional tibial interlocking intramedullary nail and anatomical type tibial nails in the treatment of tibial fractures of distal segment of open fractures, by using reamed technology is conforming to the fracture internal fixation requirements.Reamed technology did not increase the risk of infection.The effect is ideal.