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find Keyword "交锁髓内钉" 16 results
  • 克氏针提拉复位髓内钉固定治疗粉碎性股骨干骨折

    目的 总结克氏针提拉闭合复位、交锁髓内钉内固定治疗粉碎性股骨干骨折的临床疗效。 方法 2008 年4 月- 2010 年3 月,采用克氏针提拉闭合复位、交锁髓内钉内固定治疗新鲜粉碎性股骨干中段骨折23 例。其中男19 例,女4 例;年龄27 ~ 55 岁,平均35 岁。致伤原因:交通事故伤18 例,重物砸伤5 例。左侧10 例,右侧13 例。骨折按Winquist-Hansen 分级:Ⅰ级11 例,Ⅱ级6 例,Ⅲ级3 例,Ⅳ级3 例。受伤至手术时间2 ~ 5 d。 结果 手术时间40 ~ 90 min,平均55 min;术中出血量100 ~ 500 mL,平均310 mL。术后切口均Ⅰ期愈合。23 例均获随访,随访时间13 ~ 30 个月,平均16 个月。X 线片示22 例骨折愈合良好,愈合时间8 ~ 17 个月,平均13 个月;1 例Ⅳ级骨折患者因活动过多,骨折愈合迟缓,经予以制动4 个月后愈合。无深静脉血栓形成、断钉、感染等并发症发生。末次随访时按刘兴炎等股骨干骨折疗效评定标准,获优22 例,良1 例,优良率达100%。 结论 克氏针提拉闭合复位交锁髓内钉内固定治疗粉碎性股骨干骨折,手术方法简便、并发症少、骨折愈合率高。

    Release date:2016-08-31 05:42 Export PDF Favorites Scan
  • EFFECT OF INTERLOCKING INTRAMEDULLARY NAIL IN TREATMENT OF OPEN TIBIAL AND FIBULA FRACTURES

    Objective To determine the effect of interlocking intramedullary nail in treatment of open tibial and fibula fractures and analyze the method to promote the bone union. Methods From December 2003 to June 2006, thirtyfive patients with open tibial and fibula fracture were treated with emergency debridement, interlocked intramedullary fixation for tibia and fixed fibula at the same time. During operation, the bone marrow was collected and grafted into the fracture gaps. Among them, there were 27 males and 8 females, involving in 22 left legs and 13 right legs. Their ages ranged from 19 to 65 years, with an average of 34.7 years. The location of fracture was the middle of the tibia and fibula in 16 cases, the distal 1/3 of the tibia and fibula in 12 cases and the proximal 1/3 in 7 cases. According to the Gusitilo classification of open injuries, there were 7 cases of type I, 19 cases of type II, 8 cases of type III a and 1 case of type III b. The mean range of knee motion was 48.3° (45-70°). The mean time from injury to operation was 4.3 hours (50 minutes to 7 hours). Results The mean operation time was 94 minutes (60-132 minutes) and the mean blood loss was 122 mL (100-350 mL). The wound healed by first intention in 32 patients. Incision was sutured in 2 cases of type III a fractures after operation 4 days, gastrocnemius flap graft was performed in 1 case of type III b fracture 1 week after operation. They all achieve good heal ing. No fractures spl it off, no iatrogenic nerve and vascular injury occurred, no osteofascial compartment syndromes or deep vein thrombus happened. Tension bl isters appeared in 1 case of type II fracture after operation and subsided after 5 days. Patients were followed up for 14-43 months (mean 22 months). The X-ray films showed that fracture union was observe in 30 cases after 14 weeks of operation, in 3 cases after 18 weeks and in 1 caseafter 22 weeks of operation. The fractures union time was 15.2 weeks on average. About 2 cm nonunion in lateral tibial appeared in 1 case of type I fracture. No fracture occurred again. The mean range of knee motion was 127° (121-135°). The mean HSS score was 96.5 (87-100) at the end of the follow-up. The excellent and good rate was 100%. Conclusion The curative effect of interlocking intramedullary nail is definite in treatment of open tibial and fibula fractures and it can enhance fracture union to plant bone marrow into the fracture gaps.

    Release date:2016-09-01 09:05 Export PDF Favorites Scan
  • 创伤性浮膝合并血管损伤的治疗

    目的 总结创伤性浮膝合并血管损伤的手术方法及疗效。 方法 2001 年3 月- 2008 年3 月收治23 例创伤性浮膝合并血管损伤。男14 例,女9 例;年龄21 ~ 63 岁。车祸伤15 例,高处坠落伤5 例,重物砸伤3 例。开放骨折16 例,按照Gustilo 分型:Ⅰ型8 例,Ⅱ型6 例,Ⅲ型2 例。血管损伤类型:横行断裂12 例,纵行裂伤4 例,挫伤缺损4 例,内膜损伤栓塞3 例。受伤至入院时间为30 min ~ 4 h,平均2 h。采用小切口复位股骨逆行交锁髓内钉联合胫骨外固定器固定,同时修复血管。 结果 骨折均获解剖复位。术后外固定针道感染3 例。4 例于术后7 ~ 10 d 出现切口浅表感染,其余切口均Ⅰ期愈合。1 例于术后12 d 因缺血坏死、感染行截肢术,余22 例保全肢体。22 例术后获随访,随访时间14 ~ 38 个月,平均18.5 个月。骨折均愈合,愈合时间为15 ~ 24 周。术后1 年肢体功能按Karlstrouml;m 等评价标准,优10 例,良8 例,中3 例,差1 例。 结论 小切口复位股骨逆行交锁髓内钉联合胫骨外固定器固定,同时修复血管,是治疗创伤性浮膝合并血管损伤的一种较好选择。

    Release date:2016-09-01 09:08 Export PDF Favorites Scan
  • A BIOMECHANICAL STUDY ON INTERNAL AND EXTERNAL FIXATION DEVICES FOR TREATMENT OFHUMERAL SHAFT FRACTURE

    To provide the scientific theoretical basis for cl inical practice by comparing biomechanicalcharacteristics of single compressed plate with intramedullary pin, locking intramedullary nail and simple arm externalfixator with simple internal fixation devices. Methods Eighteen wet humeral bone specimens of adult cadaver were madecompl icated fracture models of humeral shaft and divided into 3 groups according to fixation methods. Fracture was fixed by single compressed plate with intramedullary pin in plate group, by locking intramedullary nail in intramedullary nail group and by external fixator with simple internal fixation devices in external fixator group. The intensity and rigidity of compl icated fracture models of humeral shaft was measured in compress test and torsion test. Results In compress test, the maximum load in plate group (6 162.09 ± 521.06) N and in intramedullary nail group (6 738.32 ± 525.89) N was significantly larger than that in external fixator group (2 753.57 ± 185.59) N (P lt; 0.05); but there was no significant difference between plate group and intramedullary nail group (P gt; 0.05). Under 600 N physiological compress load, the rigidity was (171.69 ± 6.49) N/mm in plate group, (333.04 ± 36.85) N/mm in intramedullary nail group and (132.59 ± 2.93) N/mm in external fixator group; showing no significant difference between plate group and external fixator group (P gt; 0.05), and showing significant difference between intramedullary nail group and plate, external fixator groups (P lt; 0.05). In torsion test, the maximum torque in plate group (38.24 ± 7.08) Nm was significantly larger than those in intramedullary nail group (17.12 ± 5.73) Nm and external fixator group (20.26 ± 6.42) Nm (P lt; 0.05), but there was no significant difference between intramedullary nail group and external fixator group (P gt; 0.05). Under 0.80 Nm physiological torque, the rigidity was (16.36 ± 2.07) Ncm/° in plate group and (18.79 ± 2.62) Ncm/° in external fixator group, which was significantly larger than that in intramedullary nail group (11.45 ± 0.22) Ncm/° (P lt; 0.05); but there was no significant difference between plate group and external fixator group (P gt; 0.05). Conclusion Those fracture models fixed by single compressed plate with intramedullary pin have better compress and torsion intensity, they also have better torsion rigidity but less compress rigidity. Those fracture models fixed by locking intramedullary nail have better compress intensity but less torsion intensity, they also have better compress rigidity but less torsion rigidity. Those fracture models fixed by external fixator with simple internal fixation device have less compress and torsion intensity, they also have less compress rigidity but better torsion rigidity.

    Release date:2016-09-01 09:12 Export PDF Favorites Scan
  • FEMORAL SHAFT FRACTURE TREATED WITH CLOSED REDUCTION AND INTRAMEDULLARY NAILING

    【Abstract】 Objective To discuss the techniques and advantages of closed reduction and intramedullary nail ing intreating femoral shaft fracture without cannulated femoral reamer. Methods From January 2006 to June 2007, 24 cases offemoral shaft fracture were treated with closed reduction and intramedullary nail ing. Among them, there were 14 males and 10 females, with the average age of 38.3 years (ranging from 18 years to 63 years), with 7 left legs and 17 right legs. The average course of the disease was 7.6 days (ranging from 3 days to 20 days). According to the AO typing, there were 5 cases of type A, 6 of type B, 7 of type C1, 2 of type C2 and 4 of type C3. Closed reduction was achieved with manipulation and reaming of femoral canal was instructed by fluoroscopy. Results The operation time lasted from 100 minutes to 170 minutes, with the average time of 128.3 minutes. One patient was given a transfusion of 400 mL, and others were not. Twenty cases were followed up with the average time of 13.1 months (ranging from 6 months to 24 months). A mild to large amount of bony callus was showed on X-ray films 6 to 12 weeks postoperatively. Walking without crutches began at the average week of 22.2 (ranging from 15 to 30) postoperatively. Range of motion of the knee was 0° to 145.5°. No infection or break of the internal fixator occurred. Myositis ossificans with pain and insufficient flexion of hip (120°) happened in 1 case and the pain disappeared after non-steroid anti-inflammatory drugs were taken. Nonsymptomatic myositis ossificans occurred in 2 cases and no treatment was needed. Conclusion Closed reductionand intramedullary nail ing can help to protect the blood supply of fracture fragments and provide central fixation. The operation process will be more compl icated if cannulated femoral reamer is not available.

    Release date:2016-09-01 09:12 Export PDF Favorites Scan
  • 交锁髓内钉治疗股骨干骨折

    目的 总结交锁髓内钉治疗股骨干骨折的临床经验。方法 2000年6月~2004年6月,收治股骨干骨折35例,男21例,女14例;年龄16~69岁,平均31.5岁。其中车祸伤19例,摔伤6例,工地外伤3例,坠落伤7例。开放性骨折13例,Anderson分型Ⅰ型8例,Ⅱ型5例;闭合性骨折22例。新鲜骨折于伤后4 h~5 d、陈旧性骨折于伤后25~56 d入院。35例均采用交锁髓内钉治疗。结果 35例获随访6~49个月。术后达骨性愈合25例(71.4%),平均愈合时间5.4个月,12~16个月取出内固定;4~8个月临床愈合9例(25.7%);5个月骨折延迟愈合1例,经取出上端横行锁钉,改为动力型髓内钉固定4个月后骨性愈合。随访期内无感染,髓内钉无折弯和折断,无畸形愈合;锁钉折断与退出各1例。35例功能锻炼后,髋、膝关节功能均基本恢复正常。结论 交锁髓内钉能防止肢体短缩和旋转,骨折固定牢靠,愈合率高,是治疗股骨干骨折的首选内固定方法。

    Release date:2016-09-01 09:20 Export PDF Favorites Scan
  • EFFECT OF BLOCKING SCREWS ON BREAKAGE OF INTERLOCKING INTRAMEDULLARY NAILS

    Objective To explore the effect of blocking screws on the breakage of interlocking intramedullary nails. Methods From January 2003to August 2005, 56 patients with fresh and close fracture of long shafts were treated by interlocking intramedullary nails. Among them, there were 32 males and 24 females, including 26 femoral fracture and 30 tibial fracture. Fracture of femoral and tibialshaft was fixed with interlocking intramedullary nails normally in group Ⅰ(n=32). And long oblique, spiral, proximal or distal fracture of bone shaft was fixed with interlocking intramedullary nails and blocking screws in group Ⅱ(n=24). Results All cases were followed up 12 to 21 months(16 months on average). In group Ⅰ, fracture healing failed and the intramedullary nails broke in 3 cases, breakage site was the middle femoral fracture area in 1 case and the first distal interlocking nail hole in 2 cases of distal 1/3 tibial fracture. Fractures healed 6 to 12 months after operations in the other cases, but more bony callus occurred in fracture area. In group Ⅱ, fractures healing and good alignment were achieved, and no breakage was found in all 24cases. Conclusion The use of blocking screws added to interlocking intramedullary nails could improve the stability of fracture areas distinctively, and hence reduce the breakage of intramedullary nails.

    Release date:2016-09-01 09:22 Export PDF Favorites Scan
  • COMPARISON STUDY BETWEEN FIXION EXPANDABLE INTRAMEDULLARY NAIL AND TRADITIONAL LOCKEDINTRAMEDULLARY NAIL IN TREATING CLOSED FRACTURE OF TIBIAL SHAFT

    Objective To investigate an effect of the Fixion expandable intramedullary nail on treatment of the closed fracture of the tibial shaft, and to compare the Fixion nail with the traditional locked intramendullary nail.Methods From September 1, 2005 to August 31, 2006, 79 patients (53 men, 26 women; aged 17-57 years, 37 years on average) with the closed fracture of the tibial shaft were treated with the Fixion expandable intramedullary nail, and the effect of the nail was evaluated. According to the AO classification, the patients were typed as Type 42A or Type 42B. And the patients were divided into the following two groups: the expandable intramedullary nail group (n=31) and the traditional locked intramedullary nail group (n=48). Of the 31 patents in the first group, 24 were of Type 42A and 7 were of Type 42B; of the 48 patients in the second group, 37 were of Type 42A and 11 were of Type 42B. All the patients were followed up after operation. Observation was made on the time of the bony callus development and the time of the clinical healing of the bone,and on whether there was the bone malunion, late healing, disunion or infection. The limb function was also evaluated.Results The follow-up of all the 79 patients for 4-15 months averaged 10.3 months revealed that in the expandable intramedullary nail group, the average operating time was 35 minutes (range, 20-60 minutes), with no requirement of blood transfusion. The X-ray examination showed that the bony callus developed as early as 4 weeks after operation. The clinical healing time of the bone was 3-8 months, averaged 5 months. All the patients in this group had the healing by first intention. Evaluatedby the Johner-Wruhs method, an excellent result was found in 28 patients, goodin 3 patients, and poor in none of the patients, with an excellent/good rate of100%. In the traditional locked intramedullary nail group, the average operating time was 75 minutes (range, 45-110 minutes), with no requirement of blood transfusion. The X-ray examination showed that the bony callus developed as early as 4.5 weeks after operation. The clinical healing time was 3-12 months, averaged 5.8 months. In this group, 46 patients had the healing by first intention and 2 patients had the healing by second intention. Evaluated by the JohnerWruhs method,an excellent result was found in 35 patients, good in 11 patients, and fair in 2 patients, with an excellent/good rate of 95.8%.Conclusion The expandable intramedullary nail treatment has advantages of less invasion, simpler manipulation, earlier weightbearing of the bone, quicker healing ofthe bone fracture, and fewer complications. This kind of treatment is worth popularizing in the medical practice if the indication is strictly controlled.

    Release date:2016-09-01 09:23 Export PDF Favorites Scan
  • TREATMENT OF COMMINUTED INFERIOR FEMORAL FRACTURES WITH COMBINATION OF SUPRACONDYLAR LOCKED INTRAMEDULLARY NAIL AND SHAPE MEMORY BLOCK HOOP INTERNAL FIXATOR UNDER ARTHROSCOPY

    Objective To investigate the advantages and the clinical outcomes of the treatment of comminuted inferior femoral fractures with combination of supracondylar locked intramedullary nail and shape memory block hoop internal fixator under arthroscopy. Methods From June 2002 to December 2004, 12 cases of comminuted inferior femoral fractures were treated(9 males, 3 females). Of them, 5 cases were classified as type B and 7 cases as type C according to AO classification . All cases were treated with combination of supracondylar locked intramedullary nail and shape memory block hoop internal fixator under arthroscopy. In 12 cases of one-stage bone grafting, there 5 of autologous cancellous bone grafting and 7 allo-freeze drying bone grafting.Results With a follow-up of 6 to 18 months, all fractures healed within 3 to 6 months. There were no infection and nonunion. The function of all the knees joint was excellent. According to Noye’s criterion for knee scoring, the results were excellent in 9 cases and good in 3 cases; the excellent and good rate was 100%. Conclusion It is a good method to treat comminuted inferior femoral fractures with combination of supracondylar locked intramedullary nail and shape memory block hoop internal fixator under arthroscopy. It has many advantages of less injury to knee joint, good anatomic reduction and reliable fixation. 

    Release date:2016-09-01 09:26 Export PDF Favorites Scan
  • 逆行交锁髓内钉在股骨远端骨折中的应用

    Release date:2016-09-01 09:26 Export PDF Favorites Scan
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