Whittle A P, Russell T A, Taylor J C, Lavelle D G
Department of Orthopaedic Surgery, University of Tennessee-Campbell Clinic, Memphis 38103.
J Bone Joint Surg Am. 1992 Sep;74(8):1162-71.
Fifty open fractures of the tibial shaft that were treated with débridement and interlocking nailing without reaming were followed for an average of twelve months. Most of the fractures were the result of high-energy trauma, and 68 per cent of the fracture wounds were grade III. Forty-eight (96 per cent) of the fifty fractures united at an average of seven months; there were no malunions. There were four infections (8 per cent), all at the sites of grade-III fractures. Locking screws broke in five tibiae (10 per cent), but the breakage did not result in a loss of reduction. Three nails broke, two at the sites of ununited fractures and one at the site of a healed fracture. These results are comparable with, or better than, those obtained with other forms of fixation, including immobilization with a cast, unlocked intramedullary nailing, and external fixation.
对50例胫骨干开放性骨折患者进行清创及非扩髓交锁髓内钉固定治疗，平均随访12个月。大多数骨折由高能创伤所致，68%的骨折伤口为Ⅲ级。50例骨折中有48例（96%）平均在7个月时愈合，无畸形愈合。发生感染4例（8%），均位于Ⅲ级骨折部位。5例胫骨（10%）的锁定螺钉断裂，但骨折未因螺钉断裂而出现复位丢失。有3根髓内钉断裂，2根位于未愈合骨折部位，1根位于已愈合骨折部位。这些结果与其他固定方式（包括石膏固定、非锁定髓内钉固定和外固定）所获得的结果相当，甚至更好。
