Tibial shaft malunion treated with reamed intramedullary nailing: a revised technique

被引:0
作者
C. C. Wu
W. J. Chen
C. H. Shih
机构
[1] Department of Orthopedics,
[2] Chang Gung Memorial Hospital,undefined
[3] 5 Fu-Hsin St. 333,undefined
[4] Kweishan,undefined
[5] Taoyuan,undefined
[6] Taiwan e-mail: ccwu@mail.cgu.edu.tw,undefined
[7] Tel.: 886-3-3281200,undefined
[8] ext. 2163,undefined
[9] Fax: 886-3-3278113,undefined
来源
Archives of Orthopaedic and Trauma Surgery | 2000年 / 120卷
关键词
Intramedullary Nail; Deep Infection; Union Rate; Tibial Shaft; Good Exposure;
D O I
暂无
中图分类号
学科分类号
摘要
Thirty-seven consecutive adult tibial shaft malunions which had not undergone surgical treatment were prospectively treated with reamed intramedullary nailing. Indications for this treatment modality included a malunion of a tibial shaft which had only been conservatively treated, lesion level fitting for traditional or locked reamed intramedullary nail fixation, less than 2 cm shortening, and without evidence of deep infection at present. The malunions were treated with fibulotomy, closed wedge tibial osteotomy, open reaming of the marrow cavity, stable reamed intramedullary nail stabilization with or without supplementation, and cancellous bone grafting. Thirty-four (92%) patients were followed up for at least 1 year (range 1.0–4.3 years), and all achieved a solid union. The union period was 5.8±0.8 months. Complications included 2 (6%) patients with deep infection and 1 (3%) with cortical perforation. However, all 3 patients recovered completely after adequate management. In conclusion, a reamed intramedullary nail is an ideal instrument for tibial shaft malunions in indicated cases. Good exposure of the bony segments to ream the marrow cavity precisely can avoid cortical perforation. Gentle dissection of the soft tissues may lower the infection rate. Concomitant cancellous bone grafting can improve the union rate.
引用
收藏
页码:152 / 156
页数:4
相关论文
empty
未找到相关数据