| 交锁髓内钉治疗胫骨下段骨不连 |
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Received:March 23, 2005
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| 作者 | Author | 单位 | Unit | E-Mail |
| 陈可新 |
CHEN Ke-xin |
洛阳正骨医院骨不连科,河南洛阳471002 |
Department of non-union,Luoyang Traditional Chinese Orthopedics and Traumatology Hospital of Henan,Luoyang 471002,Henan,China |
kexin_1221@163.com |
| 张春建 |
ZHANG Chun-jian |
洛阳正骨医院骨不连科,河南洛阳471002 |
Department of non-union,Luoyang Traditional Chinese Orthopedics and Traumatology Hospital of Henan,Luoyang 471002,Henan,China |
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| 刘兴才 |
LIU Xing-cai |
洛阳正骨医院骨不连科,河南洛阳471002 |
Department of non-union,Luoyang Traditional Chinese Orthopedics and Traumatology Hospital of Henan,Luoyang 471002,Henan,China |
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| 阮成群 |
RUAN Cheng-qun |
洛阳正骨医院骨不连科,河南洛阳471002 |
Department of non-union,Luoyang Traditional Chinese Orthopedics and Traumatology Hospital of Henan,Luoyang 471002,Henan,China |
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| 李光明 |
LI Guangming |
洛阳正骨医院骨不连科,河南洛阳471002 |
Department of non-union,Luoyang Traditional Chinese Orthopedics and Traumatology Hospital of Henan,Luoyang 471002,Henan,China |
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| 期刊信息：《中国骨伤》2005年18卷，第12期，第711-712页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:探讨交锁髓内钉治疗胫骨下段骨不连的有效性。
方法:2000年4月-2004年2月,应用交锁髓内钉治疗胫骨下段骨不连45例,男28例,女17例;年龄20~58岁,平均38岁。其中肥大型18例,萎缩型14例,营养不良型13例。骨折冠状面成角0°~22°,平均8°;矢状位成角为0°~16°,平均5°。从受伤到交锁髓内钉固定时间为5~12个月,平均7个月。原始创伤为开放性骨折12例,闭合性骨折33例。无大于1.5 cm的节段性骨质缺损。4例胫骨下段肥大型骨不连闭合置入髓内钉,折端未植骨;4例胫骨下端骨不连（肥大型1例,营养不良型3例）应用改良髓内钉治疗。所有病例均采用静力型固定。
结果:经7~14个月（平均10个月）随访,44例经3~5个月获得愈合,平均愈合时间3.8个月。1例术后8个月骨折未愈合,经切开植骨、辅助石膏外固定3个月后愈合。术后无活动性感染及慢性骨髓炎发生。
结论:交锁髓内钉固定治疗胫骨下段骨不连具有良好的矫正畸形能力和最少量软组织剥离的优点。 |
| [关键词]:胫骨骨折 骨折,不愈合 骨折固定术,髓内 |
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| Locked intramedullary nailing in the treatment of non-union of the distal tibia |
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Abstract:
Objective:To explore the therapeutic effects of locked intramedullary nailing in the treatment of non-union of the distal tibia.
Methods:Forty-five patients with non-union of the distal tibia were treated with locked intramedullary nailing from 2000.4 to 2004.2.Among them,28 patients were male and 17 female,ranging in age from 20 to 58 years(mean 38 years).Eighteen patients were hypertrophic non-unions,14 atrophic non-unions and 13 dystrophy non-unions.Coronal plane deformity averaged 8 degree(ranged from 0 to 22 degree) and sagittal plane deformity 5 degree(from 0 to 16 degree).The average time from initial fractures to our treatments of nonunions was 7 months(ranged from 5 to 12 months).Twelve initial fractures were open injuries and others were closed.The segmental bone defects were not more than 1.5 cm.Four patients with hypertrophic non-unions of the distal tibia were treated with closed nailing without adjuvant bone grafting.Existing nails were modified for the treatment of very distal tibial fractures(1 hypertrophic and 3 oligotrophic non-unions).All the patients were statically locked for fixation.
Results:All the patients were followed up from 7 to 14 months(mean 10 months).Forty-four patients achieved re-union with an average of 3.8 months(ranged from 3 to 5 months) after locked intramedullary nailing.Non-union occurred still existed in one patient 8 months after operation.Being further treated with bone grafting and plaster external fixation for 3 months the patient was also completely recovered.No active infections and chronic osteomyelitis happened after surgery.
Conclusion:Locked intramedullary nailing is a reliable and safe method in the treatment of non-union of the distal tibia.It can produce excellent correction of deformity with minimal soft-tissue dissection. |
| KEYWORDS:Tibial fractures Fractures,ununited Fracture fixation,intramedullary |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 陈可新,张春建,刘兴才,阮成群,李光明.交锁髓内钉治疗胫骨下段骨不连[J].中国骨伤,2005,18(12):711~712 |
| 英文格式: | CHEN Ke-xin,ZHANG Chun-jian,LIU Xing-cai,RUAN Cheng-qun,LI Guangming.Locked intramedullary nailing in the treatment of non-union of the distal tibia[J].zhongguo gu shang / China J Orthop Trauma ,2005,18(12):711~712 |
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