The curative effect analysis of interlocking intramedullary nail for treatment of long bone fracture / 中华骨科杂志

ABSTRACT

Objective To probe the effects of interlocking intramedullary nail fixation in treatment of long bone fractures, evaluate the application of intramedullary nail fixation treatment of long bone fractures, and explore the complications and their management. Methods Retrospective study of 2126 cases with long bone fracture treated with interlocking intramedullary nail from January 1996 to January 2004 was carried out. Of them, 1089 cases were followed up, and the average follow-up duration was 4 years (1 to 8 years). The locations of fracture were tibial and fibular in 603 cases, which were left in 237 cases and right in 331 cases and bilateral in 35 cases, close fracture in 511 cases of type C 240 cases, type A of 134 cases and type B 137 cases, open fracture 92 cases of Gustilo Ⅰ type 63 cases and Gustilo Ⅱ type 29 cases; femoral fractures in 360 cases, which were left 136 cases, right 205 cases and bilateral 19 cases, close fracture 319 cases of type C 191 cases, type A 103 cases, type B 25 cases; Open fracture 41 cases; Humeral fractures in 126 cases, which were left 49 cases, right 71 cases and bilateral 6 cases, close fracture 113 cases of type C 24 cases, type A 64 cases and type B 25 cases; Open fracture 13 cases. Results Fracture healing rate was 93% in interlocking intramedullary nail fixation treatment of long bone fracture. Complication included fracture nonunion rate 7%, infection rate 3%, fat embolism syndrome 2%, nail and locking bolts broke 2%, iatrogenic fracture 1.3%, knee pain in patients with tibia shaft fracture after interlocking intramedullary nail treatment 35%. Conclusion Interlocking intramedullary nail is more suitable for long bone fracture because it can result in more reliable fixation, less operative trauma. It can be used as the first alternative to treat long bone fractures.