Rommens P M, Pairon P, Kuhn S
Zentrum für Orthopädie und Unfallchirurgie, Universitätsmedizin, Johannes Gutenberg-Universität Mainz, Deutschland.
Unfallchirurg. 2013 Sep;116(9):831-46. doi: 10.1007/s00113-013-2499-6.
Nailing of metaphyseal fractures demands thorough preoperative planning. The trauma surgeon has to take the specific morphology of the fracture, the individual anatomy of the broken bone, and the design and characteristics of the selected implant into consideration. The fracture has to be precisely reduced and the reduction controlled during nail insertion. The reduction technique and reduction aids must be chosen preoperatively. The nail has to be introduced with care and brought to its correct and ideal position. Only after successful proximal and distal interlocking can the nail become the central weight bearing implant, which holds the fracture stable and reduced. In the following contribution, the specific problems of reduction and nail fixation of metaphyseal fractures of the proximal humerus, proximal and distal femur, and proximal and distal tibia together with the needed reduction and fixation aids are presented.
干骺端骨折的髓内钉固定需要进行全面的术前规划。创伤外科医生必须考虑骨折的具体形态、骨折骨的个体解剖结构以及所选植入物的设计和特点。骨折必须精确复位，并在插入髓内钉过程中控制复位情况。复位技术和复位辅助工具必须在术前选定。髓内钉必须小心插入并置于正确的理想位置。只有在近端和远端成功锁定后，髓内钉才能成为中央承重植入物，使骨折保持稳定并复位。在以下论述中，将介绍肱骨近端、股骨近端和远端以及胫骨近端和远端干骺端骨折复位和髓内钉固定的具体问题以及所需的复位和固定辅助工具。
