Kreusch-Brinker R, Schwetlick G
Orthopädische Universitäts- und Poliklinik im Oskar-Helene-Heim Berlin.
Unfallchirurgie. 1990 Oct;16(5):236-43. doi: 10.1007/BF02589876.
The indication for nailing a femur or tibia fracture has been extended by the method of interlocking up to the meta/diaphyseal zone. For the stabilisation of osteotomies in these regions, the nail was used in 19 cases of femur and 23 of tibia corrections between 1983 and 1988 in the Orthopedic University Clinic Berlin. The osteotomies were done with a small skin incision in open way. Although there were three infections, bone consolidation was succeeded in all but one patient with the planned axis. The first achieved gain in length could not be hold in five cases after removing the interlocking screws in order to give full weight bearing to the leg for callus formation. In situations of non-unions with wrong position or refracture of biologically troubled bones after plating the method of interlocking nail is stable and enables bone recovery after grafting by drilling. The possibility of early full weight bearing is a great advantage for the rehabilitation of patients, who had been suffering from delayed fracture healing before. The nail itself preserves the right position of the bone in two dimensions, even if there are not exact fitting osteotomy fragments, and the interlocking screws secure the shorter part of diaphysis against malrotation.
通过交锁髓内钉技术,股骨或胫骨骨折的髓内钉固定适应证已扩展至干骺端/骨干区域。1983年至1988年间,在柏林大学骨科诊所,使用髓内钉对19例股骨和23例胫骨进行截骨矫正以稳定这些部位的截骨。截骨通过小切口开放进行。尽管发生了3例感染,但除1例未达到计划的轴线外,其余患者均实现了骨愈合。为了让腿部完全负重以促进骨痂形成,5例患者在拆除交锁螺钉后,最初获得的肢体延长未能维持。对于钢板固定后出现位置不佳的骨不连或生物力学不稳定的骨再骨折情况,交锁髓内钉技术稳定,通过钻孔植骨后可实现骨愈合。早期完全负重的可能性对于曾患有延迟性骨折愈合的患者康复具有很大优势。即使截骨块不完全匹配,髓内钉本身也能在二维平面上保持骨的正确位置,而交锁螺钉可防止骨干较短部分发生旋转畸形。