Dueland R T, Johnson K A, Roe S C, Engen M H, Lesser A S
Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison 53706, USA.
J Am Vet Med Assoc. 1999 Jan 1;214(1):59-66.
To determine results of using interlocking nails (IN) for fixation of diaphyseal long bone fractures in dogs.
Multi-center prospective clinical trial.
134 dogs with diaphyseal fractures of the femur (n = 92), tibia (23), or humerus (19); 11 had previous unsuccessful treatments, and 103 had comminuted fractures of which 70 were classified as unstable.
All fractures were stabilized with 6- or 8-mm-diameter IN with 3.5- or 4.5-mm screws, respectively. Cerclage wires and an autogenous bone graft were used at the surgeon's discretion. Participating surgeons provided information on age, sex, weight, and breed of the dog, details of the surgery, details of any intra- or postoperative complications, fracture healing time, and limb function.
Eight dogs were lost to follow-up evaluation. In 105 of the remaining 126 dogs (83%), fractures healed without complications. For these 105 dogs, limb function was excellent (n = 90), good (12), fair (2), and poor (1). Complications developed for 21 dogs (17%); limb function after additional treatment was excellent (n = 10), good (2), fair (5), poor (1), or unreported (3). Interlocking nails broke in 9 dogs; breakage was attributed to fatigue failure because of use of too small an IN or because of insertion of the IN so that a screw hole was positioned at the fracture site.
The high success rate and low complication rate suggest that IN can be used to stabilize diaphyseal fractures in dogs. Good technique is necessary for optimal results.
确定使用交锁髓内钉（IN）固定犬骨干长骨骨折的效果。
多中心前瞻性临床试验。
134只患有股骨干骨折（n = 92）、胫骨干骨折（23只）或肱骨干骨折（19只）的犬；11只曾有过治疗失败，103只患有粉碎性骨折，其中70只被归类为不稳定骨折。
所有骨折分别用直径6或8毫米的IN及3.5或4.5毫米的螺钉进行固定。环扎钢丝和自体骨移植由外科医生酌情使用。参与的外科医生提供了犬的年龄、性别、体重和品种信息、手术细节、任何术中或术后并发症细节、骨折愈合时间和肢体功能情况。
8只犬失访。在其余126只犬中的105只（83%），骨折愈合且无并发症。对于这105只犬，肢体功能优秀（n = 90）、良好（12）、尚可（2）和差（1）。21只犬（17%）出现并发症；经额外治疗后的肢体功能优秀（n = 10）、良好（2）、尚可（5）、差（1）或未报告（3）。9只犬的交锁髓内钉断裂；断裂归因于使用的IN过小或IN插入时螺钉孔位于骨折部位导致的疲劳失效。
高成功率和低并发症发生率表明IN可用于稳定犬的骨干骨折。为获得最佳效果，良好的技术是必要的。
