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胫骨干骨折髓内钉固定的流行病学及预后:一项回顾性多中心队列研究

Epidemiology and Outcomes of Intramedullary Nailing for Tibial Diaphyseal Fractures: A Retrospective Multicenter Cohort Study.

作者信息

Rodrigues Fábio Lucas, Ferrari Ana Lya Moya, Faria Fernando Ferraz, Pinto Rafael Luiz Emmanoel, Lopes Manuela Fernandes, Santos Maria Eduarda Alencar, Varela Evelyn Cardenas, Lopes Filho Manuel Jucelino, Cecyn Marianna Nogueira, De Oliveira Nelson Henrique Carvalho

机构信息

Orthopedics and Traumatology, Santo André, São Bernardo do Campo, and São Caetano do Sul (ABC) Medical School, Santo André, BRA.

Research and Development, Biomecanica, Jaú, BRA.

出版信息

Cureus. 2025 Apr 24;17(4):e82894. doi: 10.7759/cureus.82894. eCollection 2025 Apr.

Abstract

BACKGROUND

Intramedullary nails (IMN) are frequently used to fix tibial diaphyseal fractures. Despite good outcomes, complications such as infections, malunion, and nonunion may still occur, especially in low- and middle-income countries where healthcare resources and trauma care systems are often limited. This retrospective multicenter cohort study aimed to evaluate the epidemiology and clinical outcomes of IMN in tibial diaphyseal fractures in Brazil in terms of consolidation and complications.

MATERIALS AND METHODS

We analyzed data from 125 patients who underwent IMN for fixation of tibial diaphyseal fractures between August 2020 and January 2024 at two Brazilian hospitals.

RESULTS

Traffic accidents were the most common injury mechanism (84%), and closed fractures accounted for 80.8% of the cases. Most patients (98.4%) achieved fracture consolidation within six months post-surgery, with a low complication rate (3.2%), including two nonunions with screw breakage, one malunion, and one infection. There was a significant association between previous external fixation and the type of fracture (closed and open). However, there was no significant association between previous external fixation and consolidation one year post-surgery.

CONCLUSION

The findings suggest that IMN is effective in achieving consolidation and low complication rates in Brazilian hospitals.

摘要

背景

髓内钉常用于固定胫骨干骨折。尽管治疗效果良好,但仍可能发生感染、骨不连和畸形愈合等并发症,尤其是在医疗资源和创伤护理系统往往有限的低收入和中等收入国家。这项回顾性多中心队列研究旨在评估巴西医院中髓内钉治疗胫骨干骨折的流行病学情况及在骨折愈合和并发症方面的临床结局。

材料与方法

我们分析了2020年8月至2024年1月期间在巴西两家医院接受髓内钉固定胫骨干骨折的125例患者的数据。

结果

交通事故是最常见的致伤机制(84%),闭合性骨折占病例的80.8%。大多数患者(98.4%)在术后6个月内实现骨折愈合,并发症发生率较低(3.2%),包括2例伴有螺钉断裂的骨不连、1例畸形愈合和1例感染。既往外固定与骨折类型(闭合性和开放性)之间存在显著关联。然而,既往外固定与术后1年的骨折愈合之间无显著关联。

结论

研究结果表明,在巴西医院,髓内钉在实现骨折愈合和降低并发症发生率方面是有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/404b/12102775/0592e7487392/cureus-0017-00000082894-i01.jpg

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