The treatment of extremity fractures using the interlocking nail
- VernacularTitle:带锁髓内钉治疗新鲜四肢长骨干骨折1224例疗效分析
- Author:
Lin SUN
;
Xinghua LIU
;
Xuesong WANG
- Publication Type:Journal Article
- Keywords:
Fracture fixation, intramedullary;
Fractures;
Extremities;
Treatment outcome
- From:
Chinese Journal of Orthopaedics
2001;0(03):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of the interlocking nail for extremity fractures. Methods This study reviews 1224 cases of extremity fractures treated with locking intramedullary nail fixation from October 1996 to June 2004, including 92 cases humeral shaft fracture; 210 cases intertrochanteric fractures; 488 cases femoral shaft fractures; 92 cases supracondylar femoral fractures; 342 cases tibia and fibular fractures. According to the AO classification there were 642 type A, 364 type B and 218 type C. There were 986 cases (72.4%) high-energy injury; 405 cases were multiple injury. There is 778 male and 446 female with mean age 39 years (range 16-92 years). Duration from injury to operation was 8 days(3 hour-30 days). Close reduction was 1203 cases and open reduction were 21 cases. Results Mean follow-up period is 24 months(6-70 month), mean operation time was 90 minutes(40-480 minutes). Union was in 1204 cases, union rate was 98.2%, mean union time was 5 months (3-12 months) on average, there were nonunion in 22 patients: 4 in humeral shaft, 8 in femoral shaft, 4 in supracondylar femur, 6 in tibia shaft, the nonunion rate is 1.8%. Late deep infection occurred in 3 patients: 1 in femoral shaft, 1 in supracondylar femur, 1 in intertrochanteric femur, the infection rate is 0.2%. There were 16 split in intraoperation: 4 in humeral nail, 4 in Gamma nail, 9 in supracondylar nail. Iatrogenic nerve palsy occurred in 6 patients: 2 in radial nerve, 2 in sciatic nerve, 2 in common peroneal nerve, the occurrence is 0.4%. One femoral nail was broken, locking screw were broken in 9 patients (0.6%), femoral shaft fracture of distal nail end occurred in 3 cases: 1 in Gamma nail, two in supracondylar nail. 53 patient complained uncomfortable in entry point (8 shoulders; 9 hips; 36 knees). Conclusion The result is satisfactory in bone healing low infection reduced blood loss and rapid recovery of the joint and body with the close interlocking nailing to be treatment of fresh extremity shaft fracture. It is a perfect method, however the complication should be pay more attention.
