Bhandari Mohit, Zlowodzki Michael, Tornetta Paul, Schmidt Andrew, Templeman David C
Division of Orthopaedic Surgery, Hamilton Health Sciences-General Hospital, 237 Barton Street East. Hamilton, Ontario L8L 2X2, Canada.
J Orthop Trauma. 2005 Feb;19(2):140-4. doi: 10.1097/00005131-200502000-00012.
Intramedullary nailing is the standard of care for the definitive management of lower extremity long bone fractures. Occasionally, temporary external fixation is used in fractures with severe open wounds or vascular injury before definitive intramedullary nailing. Secondary intramedullary nailing following external fixation is somewhat controversial, especially with respect to the duration of external fixation that is allowable before the risk of infection following later nailing becomes too great. Several recent studies have provided further insight into this issue.
The primary objective is to evaluate infection and nonunion rates in patients treated with temporary external fixation and secondary intramedullary nailing for lower extremity long bone fractures. The secondary objective is to evaluate whether the duration of external fixation and the interval time (defined as the time from external fixator removal to intramedullary nailing) influence the risk of infection after intramedullary nailing.
髓内钉固定术是下肢长骨骨折确定性治疗的标准方法。偶尔，在进行确定性髓内钉固定之前，对于伴有严重开放性伤口或血管损伤的骨折会使用临时外固定。外固定后二期髓内钉固定存在一定争议，尤其是关于在后期髓内钉固定后感染风险变得过高之前允许的外固定持续时间。最近的几项研究对这个问题有了进一步的见解。
主要目的是评估接受临时外固定和二期髓内钉固定治疗的下肢长骨骨折患者的感染率和骨不连发生率。次要目的是评估外固定持续时间和间隔时间（定义为从拆除外固定器到进行髓内钉固定的时间）是否会影响髓内钉固定后感染的风险。
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