【摘要】 [目的]测量、研究锁骨的解剖学特征,研制一种带锁髓内钉固定锁骨中段骨折,探讨其优缺点。[方法]通过对60根成人锁骨及5具成人新鲜尸体标本的测量、实验,测量锁骨长度,外侧段与中段夹角、中段与内侧段夹角,锁骨最窄处直径,锁骨最窄处髓腔内径等数据。设计出带锁髓内钉,采用髓内穿钉、髓外锁定的方法固定锁骨中段骨折。[结果]锁骨全长为(14.82±1.15)cm,外侧段与中段夹角、中段与内侧段夹角均为30°左右,锁骨最窄处直径为(1±0.16)cm,锁骨最窄处髓腔内径为(0.5±0.18)cm。由锁骨中段骨折端逆行穿导针并扩髓,根据锁骨的形状适度折弯髓内钉,由近端或远端插入髓腔,分别锁定远、近端,固定稳定可靠。[结论]自制带锁髓内钉固定锁骨中段骨折,手术创伤小、直视下复位满意而且固定可靠。但相关生物力学数据还有待于进一步研究。更多还原

【Abstract】 [Objective]To design an intramedullary nail for mid-shaft clavicular fractures based on the anatomic study of human clavicles.[Method]Sixty adult clavicles and 5 fresh cadaveric clavicles were used to survey data about full length,angle between lateral and middle segments,angle between middle and medial segments and the narrowest outer and inner diameter of clavicle.The designed interlocked intramedullary nail was used to fix mid-shaft clavicular fractures.[Result]The full length of clavicle was about(14.82±1.15) cm.The included angle between lateral and middle segment and included angle between middle and medial segment were all about 30°,the narrowest outer diameter of clavicle was about(1.00~0.16) cm,the narrowest inner diameter of clavicle was about(0.50~0.18) cm.After conversely placing guide pin from fracture end,expanding medullary cavity and adjusting the nail,the designed nail was inserted into the medullary cavity from the distal or proximal ends of clavicle,and the proximal and distal ends of the nail were locked by interlocked screws at last.[Conclusion]Treatment of mid-shaft clavicular fractures with the self-made nail has such advantages as less surgical invasion,visible fracture reduction and stable fracture fixation.The biomechanical properties of the nail will be further investigated.更多还原