Franklin J L, Winquist R A, Benirschke S K, Hansen S T
Swedish Medical Center, Seattle, Washington.
J Bone Joint Surg Am. 1988 Dec;70(10):1463-71.
Between 1962 and 1987, we treated fifty-six patients for sixty broken intramedullary nails, using a custom-made hook to extract the distal fragment of the nail. The charts and radiographs of all of the patients were reviewed. Thirty-nine of the nails had been inserted in a fresh fracture, which usually was comminuted; eight had been used for fixation of an osteotomy; nine, for fixation of a non-union; and four, for treatment of a pathological fracture. Several small-diameter intramedullary nails broke at the site of the fracture or non-union. In contrast, the sites of breakage in the interlocking nails were the interlocking holes and the welded junction of the top insertional portion and the proximal slot. Many of the breakages were in patients who had an unstable fracture pattern. The interval between insertion and breakage ranged from one to 120 months.
1962年至1987年间，我们使用定制钩子取出髓内钉远端碎片，治疗了56例患者的60根折断的髓内钉。回顾了所有患者的病历和X光片。其中39根钉子用于新鲜骨折的固定，这类骨折通常为粉碎性骨折；8根用于截骨固定；9根用于骨不连固定；4根用于病理性骨折的治疗。几根小直径髓内钉在骨折或骨不连部位发生断裂。相比之下，交锁髓内钉的断裂部位是交锁孔以及顶部插入部分与近端狭槽的焊接处。许多断裂发生在骨折模式不稳定的患者中。钉子插入至断裂的时间间隔为1至120个月。
