【摘要】 为了评估带锁髓内针，作者采用该法治疗胫骨骨折15例，并随访1年半。期中闭合性骨折10例，开放性骨折5例。横断、短科形骨折6例，粉碎骨折9例。手术方法，病人仰卧位，屈髋屈膝90°，在电视X线机监视下，整复骨折，打入髓内针并锁定。治疗结果，15例骨折均愈合，关节功能好，无断针，无感染。作者还提出了数项重要应用原则：（1）带锁髓内针优于普通髓内针，应用范围广，固定坚强；（2）开放性骨折应用时不扩髓，同时Ⅲ度骨折弃用；（3）开放骨折的手术时机取决于伤口情况，一期髓内外只适用于伤口污染轻，清创后有较好软组织的病人，否则应延期；（4）锁定髓内针有静力锁定和动力锁定，各有应用价值。在动力锁定时，作者主张锁定螺钉置于相对不稳定端。更多还原

【Abstract】 In Order to evaluate the intramedullary nailing wih interlocking, 15 patients with tibial tracture were treated with the device and followed-up for one year and Six months. They presented the closed fracture in 10 cases ard the open fracture in 5 cases, 6 of them being transverse fracturesor oblique fractures, 9 comminuted fractures During the operation, the patient was in supine position with hip and knee flexed 90°. Under the guidance of X-ray, the fracture was realigned and immobilized with the intramedullary locking nail. The results showed that Solid unions and good joint fuctions were obtained in all patients, and non-infection and,break of nail were occurred. In the Discuss, the authors stress several important guidlines in usage: (1) The interlock nailing is advantagious over common intramedallary nailing, i. e. the lesser limitations and stronger internal fixation; (2) as for open fracture, the nailing should be done without the reaming of medulla in Gustilo’s Type 1 and Type Ⅱ fractures whereas, it should not be suitable to Gustilo’s Type Ⅲ; (3) the timing of nailing is dependent on the wound. Primary nailing is only suitable to the mild contamination of wound and a good soft tissue coverage after clebridement.Otherwise, delayed nailing must be necessary. (4) There are two kinds of locking, dynamtic or static,each with its value respectively. In the dynamic locking, The lock screw is to be inserted at the unstable end prefebrrably.更多还原