[阻挡螺钉对带锁髓内钉断裂的影响]
[Effect of blocking screws on breakage of interlocking intramedullary nails].
作者信息
Ai Jinwei, Li Pei, Han Yeping
机构信息
Department of Orthopaedics II, the 2nd Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou Ilenan, 450002, PR China.
出版信息
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2007 Mar;21(3):282-4.
OBJECTIVE
To explore the effect of blocking screws on the breakage of interlocking intramedullary nails.
METHODS
From January 2003 to August 2005, 56 patients with fresh and close fracture of long shafts were treated by interlocking intramedullary nails. Among them, there were 32 males and 24 females, including 26 femoral fracture and 30 tibial fracture. Fracture of femoral and tibial shaft was fixed with interlocking intramedullary nails normally in group I (n=32). And long oblique, spiral, proximal or distal fracture of bone shaft was fixed with interlocking intramedullary nails and blocking screws in group II (n=24).
RESULTS
All cases were followed up 12 to 21 months (16 months on average). In group I, fracture healing failed and the intramedullary nails broke in 3 cases, breakage site was the middle femoral fracture area in 1 case and the first distal interlocking nail hole in 2 cases of distal 1/3 tibial fracture. Fractures healed 6 to 12 months after operations in the other cases, but more bony callus occurred in fracture area. In group II, fractures healing and good alignment were achieved, and no breakage was found in all 24 cases.
CONCLUSION
The use of blocking screws added to interlocking intramedullary nails could improve the stability of fracture areas distinctively, and hence reduce the breakage of intramedullary nails.
目的
探讨阻挡螺钉对带锁髓内钉断裂的影响。
方法
2003年1月至2005年8月,56例长骨干新鲜闭合性骨折患者采用带锁髓内钉治疗。其中男性32例,女性24例,包括股骨骨折26例,胫骨骨折30例。I组(n = 32)常规采用带锁髓内钉固定股骨干和胫骨干骨折。II组(n = 24)对长斜形、螺旋形、骨干近端或远端骨折采用带锁髓内钉及阻挡螺钉固定。
结果
所有病例均随访12至21个月(平均16个月)。I组中,3例骨折愈合失败且髓内钉断裂,其中1例断裂部位为股骨干中段骨折区域,2例为胫骨远端1/3骨折的第一个远端锁钉孔处。其余病例术后6至12个月骨折愈合,但骨折区域骨痂较多。II组中,24例均骨折愈合且对位良好,未发现断裂情况。
结论
在带锁髓内钉基础上加用阻挡螺钉可显著提高骨折部位的稳定性,从而减少髓内钉断裂。