Department of Family Medicine, Bowen University Teaching Hospital, Ogbomoso, Oyo State, Nigeria.
Department of Family Medicine, Bowen University, Iwo, Osun State, Nigeria.
Sci Rep. 2021 May 12;11(1):10070. doi: 10.1038/s41598-021-89544-2.
Long bone fracture care in developing countries remains largely different from that of the developed world where closed reduction and internal fixation with locked intramedullary nail is the standard treatment. This study in a developing country presents the pattern and outcome of treatment of 370 long bone fractures using the SIGN nail over a five-year period in order to underline the wide array of patients and fractures treatable with the nail. Using a prospective descriptive approach, all the 342 patients with 370 fractures of the humerus, femur and tibia treated from July 2014 to June 2019 were studied. The fractures were reduced without image intensifier or fracture table and fixed with the SIGN nail. Post-discharge, the patients were followed up at the out-patient clinic. The mean age of the patients was 43.45 years with a range of 10-99 years. Sixty-six percent were males who were mostly injured in motorcycle accidents. Femur, tibia and humerus fractures accounted for 59.7%, 28.4% and 11.9% respectively. Eighty-six percent were diaphyseal fractures, 73% were fresh and the main previous treatment was traditional bone setting. Deep infection occurred in 4.9%, 66.0% achieved knee flexion > 90° by sixth week, the majority achieved full weight bearing and could squat and smile by 12th week. The SIGN nail is versatile, useful for treating a wide range of fractures in most age groups particularly in developing countries where orthopaedic fractures are prevalent but the more sophisticated facilities are lacking or poorly maintained.
在发展中国家，长骨骨折的护理在很大程度上与发达国家不同，在发达国家，闭合复位和带锁髓内钉内固定是标准治疗方法。本研究在一个发展中国家，在五年期间使用 SIGN 钉治疗了 370 例长骨骨折，展示了这种治疗方法的模式和结果，以强调可以用这种钉治疗的广泛的患者和骨折类型。采用前瞻性描述性方法，研究了 2014 年 7 月至 2019 年 6 月期间收治的 342 例肱骨干、股骨干和胫骨干骨折的 370 例患者。骨折在没有影像增强器或骨折桌的情况下进行复位，并使用 SIGN 钉固定。出院后，患者在门诊进行随访。患者的平均年龄为 43.45 岁，年龄范围为 10-99 岁。66%为男性，主要因摩托车事故受伤。股骨干、胫骨干和肱骨干骨折分别占 59.7%、28.4%和 11.9%。86%为骨干骨折，73%为新鲜骨折，主要的既往治疗是传统的正骨。深部感染发生率为 4.9%，66.0%的患者在第 6 周时膝关节屈曲度>90°，大多数患者能够完全负重，在第 12 周时能够深蹲和微笑。SIGN 钉用途广泛，可用于治疗大多数年龄段的广泛骨折，特别是在骨科骨折较为普遍但缺乏或维护不善的复杂设备的发展中国家。
