Mayr E, Braun W, Rüter A
Klinik für Unfall- und Wiederherstellungschirurgie, Zentralklinikum Augsburg.
Chirurg. 1994 Nov;65(11):983-7.
The recently developed unreamed tibial nail (UTN) offers a new possibility for biological osteosynthesis by intramedullary stabilization for tibial fractures including those with severe closed and open soft tissue damage. In a retrospective study we compared the well established method of external fixation with unreamed intramedullary nailing for open tibial shaft fractures. The data of our first 15 cases treated primarily by UTN (Group 1) and another 15 cases comparable in etiology, severity of trauma, fracture classification, open soft tissue damage and the rate for myocutaneous flaps and skin-grafts, treated initially by external fixation (Group 2) were reviewed. Septic complications were only seen in group 2 and made necessary a lot of following additional operations. One angular deformity was seen in each group. Group 1 showed a mean hospital stay of 26.3 days compared to 75.7 days in group 2. Full weight-bearing was achieved after 1.8 months (group 1) whereas it took 4.5 months in group 2. The first clinical experience using the UTN shows an obvious advantage in comparison to fracture management by external fixation mainly due to a low complication rate and a much shorter over all surgical treatment period.
最近研发的非扩髓胫骨髓内钉（UTN）为包括伴有严重闭合性和开放性软组织损伤的胫骨骨折在内的胫骨骨折髓内固定生物接骨术提供了一种新的可能性。在一项回顾性研究中，我们将成熟的外固定方法与非扩髓髓内钉固定治疗开放性胫骨干骨折的方法进行了比较。回顾了我们最初采用UTN治疗的前15例患者（第1组）以及另外15例在病因、创伤严重程度、骨折分类、开放性软组织损伤以及肌皮瓣和植皮率方面具有可比性、最初采用外固定治疗的患者（第2组）的数据。感染性并发症仅在第2组中出现，并且需要进行许多后续的附加手术。每组均出现1例成角畸形。第1组的平均住院时间为26.3天，而第2组为7天。第1组在1.8个月后实现完全负重，而第2组则需要4.5个月。使用UTN的首次临床经验表明，与外固定治疗骨折相比具有明显优势，主要是因为并发症发生率低且整个手术治疗期短得多。
