Böstman O, Vainionpää S, Saikku K
J Trauma. 1984 Nov;24(11):964-9. doi: 10.1097/00005373-198411000-00007.
A followup study of 103 patients with long spiral or oblique fractures of the shaft of the tibia distal to the isthmus of the intramedullary canal was done. The injuries were caused by indirect violence, and consequently the soft-tissue damage was minimal while the degree of initial displacement and instability varied considerably. The initial management was conservative by closed reduction and long plaster cast. Failure to retain the fragments in an acceptable position occurred in 32 cases, and in these closed intramedullary compression nailing with the Kaessmann rod was undertaken 9 days postinjury on an average. The ultimately nailed 32 fractures had a significantly shorter clinical union time than the 71 conservatively treated fractures in spite of the initially more severe average lateral displacement. Deep infections were not seen. The malunion rate was 9% after compression nailing and 27% after conservative treatment. The functional recovery showed a marked correlation with the anatomic restoration.
对103例胫骨干峡部远端长螺旋或斜形骨折患者进行了随访研究。损伤由间接暴力所致，因此软组织损伤轻微，而初始移位和不稳定程度差异很大。初始治疗采用闭合复位和长腿石膏固定的保守方法。32例未能将骨折块维持在可接受的位置，这些病例平均在受伤后9天采用Kaessmann钉进行闭合髓内加压钉固定。尽管最初平均侧方移位更严重，但最终接受钉固定的32例骨折的临床愈合时间明显短于71例保守治疗的骨折。未发现深部感染。加压钉固定后的畸形愈合率为9%，保守治疗后的畸形愈合率为27%。功能恢复与解剖复位显著相关。
