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[带锁髓内钉治疗股骨干和胫骨干矫正截骨术]

[Corrective osteotomy of the shaft of the femur and tibia with an interlocking nail].

作者信息

Friedebold G, Kreusch-Brinker R

机构信息

Orthopädische Klinik und Poliklinik, Freien Universität Berlin im Oskar-Helene-Heim.

出版信息

Z Orthop Ihre Grenzgeb. 1988 May-Jun;126(3):326-33. doi: 10.1055/s-2008-1040210.

Abstract

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 stabilization of osteotomies in these regions, the nail was used in 16 cases of femur and 21 of tibia corrections between 1982 and 1986 in 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 of 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 of the delayed healing of their leg. 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 bone against malrotation.

摘要

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。1982年至1986年期间,在柏林大学骨科诊所,对16例股骨截骨和21例胫骨截骨患者使用髓内钉来稳定这些部位的截骨。截骨通过小切口开放进行。尽管有3例感染,但除1例患者未达到计划的力线外,其余患者均成功实现骨愈合。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长度未能维持。对于钢板固定后出现不愈合、骨折部位错位且存在生物学问题的骨,交锁髓内钉方法稳定,通过钻孔植骨后可促进骨恢复。早期完全负重的可能性对于腿部延迟愈合的患者康复极为有利。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骼的正确位置,而交锁螺钉可防止骨发生旋转畸形。

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