Ketterl R, Leitner A, Wittwer W
Abteilung für Unfall- und Wiederherstellungschirurgie, Krankenhaus Traunstein.
Zentralbl Chir. 1994;119(8):549-55.
An intramedullary stabilisation with an unreamed tibial nail (UTN) was carried out in 75 patients suffering from first (n = 45) and second (n = 30) degree open fractures. In 23 cases (8 of which had a second degree and 15 a third degree open fracture) the treatment regime was changed from external fixation (EF) to an UTN. The results were compared with 112 patients with first degree open tibial fractures treated with a reamed tibial nail (RTN). A change from EF to RTN was carried out in 93 cases (21 patients had a first degree, 55 a second degree and 17 patients a third degree open fracture). The rate of infection seen in open fractures was reduced by using an UTN for the tibia (4.5% using RTN versus 1.3% using UTN in primary implantation; 6.5% versus 4.3% in case of changing from EF to tibial nailing). The UTN does not disturb the healing of the fracture and there is no increased risk of axis deviation.
对75例患有一度（n = 45）和二度（n = 30）开放性骨折的患者采用非扩髓胫骨髓内钉（UTN）进行髓内固定。在23例患者中（其中8例为二度开放性骨折，15例为三度开放性骨折），治疗方案从外固定（EF）改为UTN。将结果与112例采用扩髓胫骨髓内钉（RTN）治疗的一度开放性胫骨骨折患者进行比较。在93例患者中（21例为一度开放性骨折，55例为二度开放性骨折，17例为三度开放性骨折），治疗方案从EF改为RTN。使用UTN治疗胫骨开放性骨折时，感染率降低（初次植入时，RTN的感染率为4.5%，UTN为1.3%；从EF改为胫骨髓内钉固定时，RTN的感染率为6.5%，UTN为4.3%）。UTN不会干扰骨折愈合，也不会增加轴线偏移的风险。
