Solooki S, Mesbahi S A R
Department of Orthopaedic Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.
Iran Red Crescent Med J. 2011 Mar;13(3):178-80. Epub 2011 Mar 1.
Reamed interlocking intramedullary nailing is considered the gold standard treatment for complex fractures of the femoral and tibial shaft. There has been some controversies about dynamization of statically locked nails, and some authors recommended routine dynamization for promotion of healing. This study aims to evaluate treatment of complex fractures in tibia and femur with static interlocking intramedullary nail method.
In a retrospective study from January 2003 to April 2008, 173 patients with femoral and tibial shaft fracture that were treated with this method were enrolled. No rod was dynamized in our patients.
All patients with tibial fractures achieved union without any need for dynamization during 12-18 weeks (mean; 13.4 weeks). Four patients developed delayed union but all achieved union without any intervention. In femoral fracture, all but one patient achieved complete union during 10-30 weeks (mean: 18.3 weeks). One patient developed non-union who was treated by an exchange nailing and iliac bone graft method. No significant complication was observed in our patients.
It is not necessary to routinely dynamize nails in tibial and femoral shaft fractures as all fractures united in acceptable alignment without any complication.
扩髓带锁髓内钉被认为是股骨干和胫骨干复杂骨折的金标准治疗方法。对于静态锁定髓内钉的动力化存在一些争议，一些作者建议常规进行动力化以促进骨折愈合。本研究旨在评估采用静态带锁髓内钉方法治疗胫骨干和股骨干复杂骨折的效果。
在一项回顾性研究中，纳入了2003年1月至2008年4月期间采用该方法治疗的173例股骨干和胫骨干骨折患者。我们的患者均未进行髓内钉动力化。
所有胫骨干骨折患者在12至18周（平均13.4周）内均实现骨折愈合，无需进行动力化。4例患者出现延迟愈合，但均未经过任何干预而实现愈合。在股骨干骨折中，除1例患者外，所有患者在10至30周（平均18.3周）内均实现完全愈合。1例患者出现骨不连，采用更换髓内钉和髂骨植骨方法进行治疗。我们的患者未观察到明显并发症。
在胫骨干和股骨干骨折中，无需常规对髓内钉进行动力化，因为所有骨折均在可接受的对线情况下实现愈合，且无任何并发症。
