Haas N, Krettek C, Schandelmaier P, Frigg R, Tscherne H
Trauma Department, Hannover Medical School, FRG.
Injury. 1993;24(1):49-54. doi: 10.1016/0020-1383(93)90084-j.
In a prospective study, 51 tibial shaft fractures with severe open or closed soft tissue damage were treated with a new, thin (8 mm or 9 mm) solid locking nail, inserted without reaming. At 6 months or more after trauma, 43 cases were reviewed. Fractures were classified according to Müller with six type A, 25 type B, and 12 type C fractures. In 13 cases there was group II (n = 8) or group III (n = 5) closed soft tissue damage (Tscherne). Of 30 open fractures, 16 were group OII, six were group OIIIA and eight were group OIIIB (Gustilo). Postoperative treatment in 42 of 44 cases was possible without additional cast or brace. Full weight bearing was achieved in 26 cases within 12 weeks, and in 42 cases within 26 weeks. In 43 cases, fracture healing occurred with a mean of 21.9 weeks (range 12-40 weeks). There was one case with valgus of 6 degrees and three cases with anterecurvatum deformities of 5 degrees to 10 degrees. In four cases there was an external rotation malalignment between 10 degrees and 20 degrees. In three cases we found an internal rotation deformity of 10 degrees to 20 degrees. Shortening between 0.5 and 1.0 cm was found in five cases, and in one case shortening was 1.5 cm. None of the patients had an osteomyelitis.
在一项前瞻性研究中，51例伴有严重开放性或闭合性软组织损伤的胫骨干骨折采用一种新型的细（8毫米或9毫米）实心锁定髓内钉治疗，无需扩髓插入。在创伤后6个月或更长时间，对43例患者进行了评估。骨折根据Müller分类，其中6例为A型，25例为B型，12例为C型骨折。13例患者存在II组（n = 8）或III组（n = 5）闭合性软组织损伤（Tscherne分型）。30例开放性骨折中，16例为OII型，6例为OIIIA型，8例为OIIIB型（Gustilo分型）。44例患者中的42例术后无需额外的石膏或支具固定。26例患者在12周内实现完全负重，42例患者在26周内实现完全负重。43例患者骨折愈合，平均愈合时间为21.9周（范围12 - 40周）。有1例出现6度外翻，3例出现5度至10度的前凸畸形。4例患者存在10度至20度的外旋畸形。3例患者存在10度至20度的内旋畸形。5例患者出现0.5至1.0厘米的短缩，1例患者短缩1.5厘米。所有患者均未发生骨髓炎。
