【摘要】 目的　为解决胫骨中下段骨折易旋转、移位、不稳定、固定难的问题 ,设计了一种组合式旋入式自锁髓内钉。方法　自1994年 6月至 1999年 4月采用该钉治疗胫骨中下段骨折 30例 ,并进行随访。与 30例采用加压钢板治疗胫骨中下段骨折疗效进行对比、分析。结果　旋入式自锁髓内钉固定术后骨折全部临床愈合 ,愈合时间 6～ 10个月 ,平均 8个月。膝关节伸、屈功能及行走正常 ,未发生针道感染、创伤性滑囊炎 ,无延迟和不愈合、髓内钉疲劳断裂及再骨折发生。采用加压钢板内固定术后发生骨外露合并继发性骨髓炎 2例 ,内固定松动拨钉 2例 ,钢板断裂 1例 ,加压螺丝钉断裂 1例 ,将两种疗效进行对比并进行统计学处理。两者有非常显著性差异 (P =0 0 0 5 ,P <0 0 1)。结论　旋入式自锁髓内钉通过纵向与髓腔内壁紧密贴合固定控制骨折断端旋转并对断端进行轴向加压 ,消除各种不利应力的干扰 ,固定效果可靠。同时最大限度地保护了骨断端的血运 ,为骨折愈合提供了优良的生物学环境 ,经临床应用效果较好。我们认为应用旋入式自锁内钉治疗胫骨中下段骨折是一种有效的好方法更多还原

【Abstract】 Objective In order to prevent and treat rotation,displacement,unstable,and difficult for fixation in distal fracture of tibial,a compound ratative-type interlocking intramedullary nailing was desiqned.Methods From June 1994 to April 1999,30 cases distal fractures of tibial were treated by the rotative-type interlocking intramedullary nailing.A comparison of results was mode between 30 cases of the rotative type mterlocking intramedullary nailing and 30 cases fixed by compression plate.Results All fractures had a clinical union in the cases fixed by the rotative-type interlocking intramednllary nailing.The healing time was 6～10 months,with an average of 8 months.All cases had good knee functions.Nobody had infection,trumatic synovitis,delayed union,and nonunion,breaking of interlocking intramedullary nail,refracture.The complication under compressive plate included 2 osteomyelitis,2 internal fixation loose and extraction,1 plate breaking,1 screw breaking.Comparing with the two methods,the effects were statiscally significant(P=0 005,P<0 01).Conclusions The rotative-type interlocking medullary nail could control the rotation and carring axial compressive to the bone frame by medullary stapping fixation,cacoethic stress interference had been elimined,result of fixtor was good.The blood supply of bone frame had been proteced,a good biology environment had supplied,we have got satisfactory effect by clinical application.Authors consider that it is a kind effection good method that using the rotative-type interlocking intramedullary nail to treat the distal fracture of tibial.更多还原