【摘要】 目的探讨双平面阻挡钉技术在胫骨干骨折交锁髓内钉治疗中的应用效果。方法 2016年3月～2017年6月对12例胫骨干骨折进行闭合复位交锁髓内钉固定,术中插入主钉后见正侧位复位欠佳,将主钉拔出,估算髓内钉通过髓腔所需直径,分别于冠状面和矢状面置入直径3. 0 mm Steinmann针,再次插入髓内钉主钉后得到满意复位。术后鼓励患者功能锻炼,定期随访复查X线片,观察骨折愈合情况。结果 12例术后平均随访8. 7月(6～12个月),均达到骨性愈合,平均愈合时间为5个月(3～6个月),患肢功能满意。膝关节功能按美国特种外科医院膝关节评分系统评分(HSS评分) 92～98分,平均95. 3分。踝关节功能按美国足踝外科学会制定的功能评分89～97分,平均94. 4分。根据Johner-Wruhs评分评估患者膝、踝关节功能:优7例,良3例,可2例,优良率为83. 3%。结论交锁髓内钉治疗胫骨干骨折,应用双平面阻挡钉技术能辅助获得冠状位、矢状位双平面满意复位,促进骨折愈合,减少并发症。更多还原

【Abstract】 Objective To investigate the effect of interlocking intramedullary nailing supplemented with biplane blocking screw for tibial shaft fractures. Methods A total of 12 patients with tibial shaft fracture between March 2016 and June 2017 treated with interlocking intramedullary nailing supplemented with biplane blocking screw were included. After inserting the main nail,the reduction of both sides was not satisfactory. Then the main nail was pulled out and the diameter needed for the intramedullary nail to pass through the medullary cavity was estimated. The 3. 0 mm Steinmann needles were placed in the coronal plane and sagittal plane,respectively. After inserting the main nail again,the satisfactory reduction was achieved. Patients were encouraged to exercise after operation,and X-ray films were followed up regularly to observe fracture healing. Results All the 12 patients were followed up for 6-12 months( mean,8. 7 months). All the patients achieved bony union within 6 months. The average union time was 5 months( range,3-6 months). The knee joint function was scored 92-98 points( mean,95. 3 points) according to the American Special Surgery Hospital Knee Joint Scoring System( HSS). The ankle joint function was scored 89-97 points( mean,94. 4 points) according to the functional score of the American foot and Ankle Surgery Society. According to the Johner-Wruhs score,the knee and ankle function was evaluated as excellent in 7 cases,good in 3 cases,and fair in 2 cases,the excellent and good rate being 83. 3%. Conclusion In the treatment of tibial shaft fractures with interlocking intramedullary nails,the application of biplane blocking screw could assist in achieving satisfactory reduction in both coronal and sagittal planes,thus promoting fracture healing and reducing complications.更多还原