Singer R W, Kellam J F
Carolinas Medical Center, Charlotte, NC, USA.
Clin Orthop Relat Res. 1995 Jun(315):114-8.
Forty-three high energy open tibial diaphyseal fractures were treated with unreamed locked intramedullary nails from 1989 to 1992, and were reviewed at a minimum of 1 year from injury. There were 6 Grade I, 2 Grade II, 16 Grade IIIA, 9 Grade IIIB, and 1 Grade IIIC open fractures. Ninety-eight percent of the fractures united in an average time of 6.1 months. However, 47% of the fractures required an additional procedure before union. Complications included 49% of fractures with malunions, 12% deep infections, 41% locking screw breakages, and 20% compartment syndromes. These results are similar to those achieved with external fixation of open tibial fractures. The unreamed locked intramedullary nail has not improved the outcome of open tibial diaphyseal fractures because the biologic consequences of the injury are of greater significance than the methods or techniques of fracture stabilization.
1989年至1992年期间，对43例高能开放性胫骨干骨折采用非扩髓带锁髓内钉治疗，并在受伤后至少1年进行随访。其中有6例Ⅰ级、2例Ⅱ级、16例ⅢA级、9例ⅢB级和1例ⅡC级开放性骨折。98%的骨折平均在6.1个月时愈合。然而，47%的骨折在愈合前需要额外的手术。并发症包括49%的骨折出现畸形愈合、12%的深部感染、41%的锁定螺钉断裂和20%的骨筋膜室综合征。这些结果与开放性胫骨骨折采用外固定的结果相似。非扩髓带锁髓内钉并未改善开放性胫骨干骨折的治疗结果，因为损伤的生物学后果比骨折固定的方法或技术更为重要。
