摘要
[目的]总结胫骨C2型骨折的临床特点,探讨带锁髓内钉微创内固定治疗胫骨C2型骨折的手术方法及疗效。[方法]自2000年5月～2006年3月采用带锁髓内钉微创内固定治疗胫骨C2型骨折30例,男21例,女9例;年龄20～63岁,平均41.5岁。闭合骨折14例采用有限扩髓带锁髓内钉治疗;开放骨折16例(包括GustiloⅠ和Ⅱ型)采用非扩髓带锁髓内钉治疗,均静力性固定。受伤距手术时间2h～12d,平均4.5d。[结果]平均随访时间为16.5个月(7～21个月)。30例均达骨性愈合,骨折愈合时间为4～9个月,平均6.2个月。按Johner-Wruch功能评价标准,优24例,良6例。无小腿骨筋膜间隔综合征、深部感染、膝前疼痛、主钉和锁钉断裂及畸形愈合发生。2例延迟愈合。[结论]胫骨C2型骨折多由高能量损伤引起,多发生于骨干区。带锁髓内钉微创内固定是治疗胫骨C2型骨折的一种较好的方法,其操作简单、手术创伤小、固定可靠、骨折愈合率高,并发症少、疗效满意。规范和微创的手术操作应予以高度重视。
[ Objective] To summarize the clinical characteristics of type C2 fractures of tibia, to study the surgical management and its results of type C2 fractures of tibia through intramedullary interlocking nail and minimal invasive internal fixation. [ Method] From May 2000 to March 2006,30 patients of type C2 fractures of tibia were treated surgically through intramedullary interlocking nail and minimal invasive internal fixation . The patients included 21 men and 9 women with a mean age of 41.5 years（ range 20 - 63 years） . Forteen closed fractures were treated by the limitedly reamed interlocking intramedullary nail. Sixteen open fractures （including Grade Ⅰ and Ⅱ injuries）were treated by the unreamed interlocking intramedullary nail. All fractures were fixed statically. The mean time from the injury to surgery was 4. 5 days （ rang,2 hours - 12 days）. [ Result] Mean follow-up period was 16. 5 months （7 - 21 months）. All patients had bony union within 4 -9 months,with the average time of bone union being 6. 2 months. The function recovery was evaluated by Johner- Wruch system in which 24 cases were excellent,3 cases were good. No osteofascial compartment syndrome of the lower leg, deep part infection, anterior kneeache, broken nails and screws and malunion were found in this series. Two cases were found delay union. [ Conclusion ] The type C2 fractures of tibia are often caused by high energy injuries. Most of type C2 fractures happen at the field of tibial shaft. The treatment of type C2 fractures of tibia using intramedullary interlocking nail and minimal invasive internal fixation has advantages of easy operation,less trauma, rigid fixation,high healing rate,lower complications,and satisfactory effect. It is a perfect method. The standard and less invasive operative methods should be paid more attention.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2007年第6期408-410,共3页
Orthopedic Journal of China
关键词
胫骨骨折
骨折固定术
髓内
微创
治疗结果
tibia fractures
fracture fixation
intramedullary
minimally invasive
treatment outcome
