Klemm K W, Börner M
Clin Orthop Relat Res. 1986 Nov(212):89-100.
The interlocking nail widens the range of indications for medullary osteosynthesis of femoral and tibial shaft fractures. Stability is achieved by transverse threaded bolts in prefabricated holes in the nail, which anchor the implant directly to cortical bone, thereby controlling length, alignment, and rotation of the limb. Two hundred eighty-three femoral and 401 tibial fractures were treated with an interlocking nail and followed for an average of 20 months. Overall, 97% of the femurs and 94.3% of the tibias were judged to have an excellent or good result, based on both clinical and radiographic parameters. Delayed union or nonunion requiring bone grafts occurred in 2% of the femurs and 0.7% of the tibias following interlocking nailing. Deep infection developed in 2.4% of the femurs and 2.2% of the tibias. All of these patients eventually healed their fractures without evidence of chronic osteomyelitis. The main advantage of interlocking nails is that surgery can be performed using closed nailing techniques, allowing early protected weight-bearing and joint motion. The rates of nonunion and infection are very low, and there is little risk of refracture after implant removal.
带锁髓内钉扩大了股骨干和胫骨干骨折髓内固定的适应证范围。通过钉体预制孔内的横向螺纹螺栓实现稳定性，这些螺栓将植入物直接固定于皮质骨，从而控制肢体的长度、对线和旋转。283例股骨干骨折和401例胫骨干骨折采用带锁髓内钉治疗，平均随访20个月。总体而言，根据临床和影像学参数判断，97%的股骨骨折和94.3%的胫骨骨折获得了优良结果。带锁髓内钉固定后，2%的股骨骨折和0.7%的胫骨骨折出现延迟愈合或不愈合而需要植骨。2.4%的股骨骨折和2.2%的胫骨骨折发生深部感染。所有这些患者最终骨折均愈合，无慢性骨髓炎迹象。带锁髓内钉的主要优点是可采用闭合穿钉技术进行手术，允许早期保护性负重和关节活动。不愈合和感染率很低，取出植入物后再骨折风险很小。
