【摘要】 目的 :对交锁髓内钉治疗长骨骨折进行临床生物力学分析。方法 :1998年 5月至 2 0 0 2年 5月应用交锁髓内钉治疗股骨骨折 65例 ,分别采用静力型股骨交锁钉内固定 2 9例 ,动力钉内固定 9例 ,重建钉固定 18例 ,逆行钉固定 9例 ;胫骨骨折 47例 ,采用静力胫骨交锁髓内钉固定 ;肱骨干骨折 15例 ,采用肱骨分叉式交锁髓内钉固定。扩髓 :股骨 47例 ,胫骨 3 6例 ,肱骨 10例。结果 :本组 12 7例中 ,骨折愈合 12 5例 ;膝、踝、肩、肘关节完全恢复正常 12 1例。结论 :交锁髓内钉治疗长骨骨折效果良好。最好选择与骨骼弯曲半径相匹配直径较大的钛髓内钉。术中扩髓与不扩髓各有优缺点。静力型交锁钉可在 6～ 8周内改为动力固定来刺激骨折愈合。交锁髓内钉固定可能出现多种并发症。更多还原

【Abstract】 Objective: To guide the clinical application by the analysis of the biomechanics in the treatment of the tubulate bone fractures using intramedullary interlocking nail. Methods: From May 1998 to May 2002, 38 cases of middle plate of femoral fractures were treated with intramedullary interlocking nail. Among them, 29 cases were used the static intramedullary interlocking nail, and 9 cases were used the dynamic intramedullary interlocking nail. 18 cases of epimere of femoral fractures were treated with reconstruction intramedullary interlocking nail. 9 cases of hypomere of femoral fractures were treated with retrograde intramedullary interlocking nail. 47 cases of tibia fractures were treated with static intramedullary interlocking nail. 15 cases of humerus fractures were treated with bidentate intramedullary interlocking nail. 47 cases of femoral fractures, 36 cases of tibia and 10 cases of humerus fractures were used reamer. 15 cases of femoral fractures and 27 cases of tibia weren changed to dynamic interal fixation from static interal fixation in 6～8 weeks after operation. Results: The fractures healing were seen in 125 cases, and not seen in 1 case of femoral fractures and 1 case of tibia. 121 cases’ function of the knee, the ankle, the shoulder and the elbow recovered to normal. 1 case of femoral fracture, 2 cases of tibia fractures of the ankle, and 1 case of humerus fracture of the shoulder had poor rehabilitation in the function of the knee. Conclusion: The good effectiveness are seen in the cases of tubulate bone fractures treated with intramedullary interlocking nail. The intramedullary nail which made with titanium, matches the bending radius of the bone, with the largest diameter possible was the best selection. The static internal fixation can be changed to the dynamic internal fixation to improve the healing of the fractures in 6-8 weeks after operation. But displacements of the fractures were seen in these cases. A few complications are seen in the cases with intramedullary interlocking nail fixation.更多还原