Puno R M, Teynor J T, Nagano J, Gustilo R B
Clin Orthop Relat Res. 1986 Nov(212):113-21.
Two hundred one tibial shaft fractures, 160 closed and 41 open (Grades I and II), were treated between January 1978 and June 1982. Sixty patients underwent closed intramedullary Arbeitsgemeinschart Osteosynthesisfragen/Association for the Study of Problems of Internal Fixation (AO/ASIF) nailing with reaming and 141 patients were treated with closed reduction and cast immobilization. Intramedullary nailing resulted in one (1.7%) nonunion, two (3.3%) infections, and no malunions. In the cast treatment group there were 14 (9.9%) delayed or nonunions, two (1.4%) infections, and six (4.3%) malunions. Within this group there were 19 early failures from either inadequate reduction or loss of reduction, which led to a change from nonoperative to operative methods of management. The interval between injury and return to work was 22 weeks in the nailed group, compared with 25.8 weeks in the cast immobilization group.
1978年1月至1982年6月期间，共治疗了201例胫骨干骨折，其中160例为闭合性骨折，41例为开放性骨折（Ⅰ级和Ⅱ级）。60例患者接受了闭合髓内 Arbeitsgemeinschart Osteosynthesisfragen/内固定问题研究协会（AO/ASIF）扩髓钉固定术，141例患者接受了闭合复位石膏固定治疗。髓内钉固定导致1例（1.7%）骨不连、2例（3.3%）感染，无畸形愈合。在石膏治疗组中，有14例（9.9%）延迟愈合或骨不连、2例（1.4%）感染、6例（4.3%）畸形愈合。在该组中，有19例因复位不充分或复位丢失导致早期治疗失败，从而导致治疗方法从非手术转为手术。髓内钉固定组受伤至恢复工作的间隔时间为22周，而石膏固定组为25.8周。
