[上肢和下肢髓内钉取出术。我们应该推荐这种手术吗？]
[Intramedullary nail removal in the upper and lower limbs. Should we recommend this operation?].
作者信息
Hora K, Vorderwinkler K P, Vécsei V, Gäbler C
机构信息
Universitätsklinik für Unfallchirurgie, Medizinische Universität Wien, Osterreich.
出版信息
Unfallchirurg. 2008 Aug;111(8):599-601, 603-5. doi: 10.1007/s00113-008-1450-8.
BACKGROUND
Absolute indications for removing intramedullary locking nails (ILN) are undisputed, but there are also relative indications when implant removal might be discussed. The aim of our study was to evaluate complications of ILN removal in the upper and lower extremities.
METHODS
Four hundred sixty (460) patients who underwent interlocking nail removal were reviewed regarding complications after removal of implants in the humerus, femur, or tibia.
RESULTS
The most common complications were delayed wound healing and wound infections. For the humerus, the complication rate of implant removals due to absolute indication was 29%, and the rate for removals due to relative indication was 12%. In the forearm, no complications were seen. Patients who underwent ILN removal in the femur or tibia for absolute indication had a 21% complication rate; the complication rate in patients with relative indication was 10%.
CONCLUSION
The complication rate of interlocking nail removal is too high to justify such a procedure without clear indication.
背景
取出髓内锁定钉（ILN）的绝对指征并无争议，但在某些情况下，也会讨论取出植入物的相对指征。我们研究的目的是评估上肢和下肢取出ILN的并发症。
方法
回顾了460例接受交锁髓内钉取出术的患者，观察其在肱骨、股骨或胫骨取出植入物后的并发症情况。
结果
最常见的并发症是伤口愈合延迟和伤口感染。在肱骨，因绝对指征取出植入物的并发症发生率为29%，因相对指征取出的发生率为12%。在前臂，未观察到并发症。因绝对指征在股骨或胫骨取出ILN的患者并发症发生率为21%；相对指征患者的并发症发生率为10%。
结论
在没有明确指征的情况下，交锁髓内钉取出术的并发症发生率过高，不足以证明该手术的合理性。
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