Schandelmaier P, Krettek C, Rudolf J, Kohl A, Katz B E, Tscherne H
Trauma Department, Hannover Medical School, Germany.
Clin Orthop Relat Res. 1997 Sep(342):164-72.
From 1987 to 1993, 41 Grade 3B open tibial shaft fractures were treated with the unreamed tibial nail or an external fixator. The method of treatment was left to the choice of the operating surgeon. Three below knee amputations were performed; three patients died; and three were lost to followup. Thirty-two patients were observed until union or for at least 1 year. There were no significant statistical differences between the two groups with respect to fracture type, fracture location, age, gender, or accompanying injuries. The unreamed tibial nail group showed significantly better results regarding time to full weightbearing, number of reoperations, isolated bone grafting, walking range, and average Karlström and Olerud score. Time to bony union, infection, and nonunion were not significantly different between the groups.
1987年至1993年期间，41例3B级开放性胫骨干骨折患者接受了非扩髓胫骨髓内钉或外固定架治疗。治疗方法由主刀医生选择。实施了3例膝下截肢手术；3例患者死亡；3例失访。32例患者被观察至骨折愈合或至少观察1年。两组在骨折类型、骨折部位、年龄、性别或合并伤方面无显著统计学差异。非扩髓胫骨髓内钉组在完全负重时间、再次手术次数、单纯植骨、行走范围以及平均卡尔斯特伦和奥勒鲁德评分方面显示出明显更好的结果。两组在骨愈合时间、感染和骨不连方面无显著差异。
