Chiu F Y, Lo W H, Chen C M, Chen T H, Huang C K
Department of Orthopedics and Traumatology, Veterans General Hospital-Taipei, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1996 Feb;57(2):124-33.
For unstable tibial fractures, there are many methods of surgical treatment. The efficacy of the Ender nail and the interlocking nail in the treatment of such fractures is examined.
One hundred and seven cases of unstable tibial shaft fractures were collected for the prospective study. Randomly, 61 tibia were fixed with interlocking nails and 46, with Ender nails. The mean follow-up period was 30.5 (23 to 40) months. The results of the different treatments were compared.
In the group with interlocking nails, the average blood loss was 265 cc; operation time was 61 minutes; hospital days were 10.4; and union time was 15.1 weeks for closed fractures and 17 weeks for Winquist-Hansen type III and IV fractures. In the group with Ender nails, the average blood loss was 135 cc, operation time was 32 minutes, hospital days were 8.3 days, and union time was 17.6 weeks for closed fractures and 22.5 weeks for Winquist-Hansen type III and IV fractures. Student t-test revealed statistically significant difference between the groups in all of the data described above. However, treatment with the different nails showed no significant difference in results for open type I and II fractures.
Ender nail still has its superior usefulness in some aspects of treatment of less comminuted unstable tibial shaft fractures, but for the more comminuted unstable tibial shaft fractures, the interlocking nail is undoubtedly better used.
对于不稳定型胫骨骨折，有多种手术治疗方法。本研究探讨了Ender钉和交锁髓内钉治疗此类骨折的疗效。
前瞻性收集107例不稳定型胫骨干骨折患者。随机选取61例胫骨采用交锁髓内钉固定，46例采用Ender钉固定。平均随访时间为30.5（23至40）个月。比较不同治疗方法的结果。
交锁髓内钉组平均失血量为265毫升；手术时间为61分钟；住院天数为10.4天；闭合性骨折愈合时间为15.1周，Winquist-Hansen III型和IV型骨折愈合时间为17周。Ender钉组平均失血量为135毫升，手术时间为32分钟，住院天数为8.3天，闭合性骨折愈合时间为17.6周，Winquist-Hansen III型和IV型骨折愈合时间为22.5周。Student t检验显示上述所有数据在两组之间存在统计学显著差异。然而，对于I型和II型开放性骨折，不同髓内钉治疗的结果无显著差异。
Ender钉在治疗粉碎程度较轻的不稳定型胫骨干骨折的某些方面仍具有优势，但对于粉碎程度较重的不稳定型胫骨干骨折，交锁髓内钉无疑是更好的选择。
