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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Primary Nailing in the Open Fractures of the Tibia-Is it worth?
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Primary Nailing in the Open Fractures of the Tibia-Is it worth?

机译：胫骨开放性骨折中的主钉-值得吗？

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Context (Background): The tibial shaft is one of the most common sites of open fractures. The specific methods of skeletal stabilization and soft tissue treatment of open fractures continue to be topics of debate in the orthopaedic traumatology.Aims: To evaluate the results of the intramedullary nailing in the open fractures of the tibia, especially in the Indian scenario.Settings and Design: An observational, descriptive study which was done at a tertiary care hospital from 2006 to 2010.Material and Methods: A prospective study was done on thirty cases which had sustained open fractures of the Gustilo and Anderson grades I, II and III, who were operated for primary intramedullary interlocking nail fixation after thorough debridement and closure of their wounds with suturing, lateral skin release, split thickness skin grafting and muscle pedicle flap, where ever necessary. All the patients were followed up for a minimum of two years.Statistical Analysis: Descriptive statistics and Fisher?s Exact test were used.Results: Of the total thirty cases, ten were of grade I, seven were of grade II, three were of grade IIIA, seven were of grade IIIB and three were of grade IIIC. Dynamization was done in nine cases. The average time to union was 16.0 weeks in the grade I cases, it was 18.3 weeks in the grade II cases, it was 23.6 weeks in the grade III A cases, it was 28.4 weeks in the grade III B cases and it was 32 weeks in the grade III C cases. The mean time to union was 20.7 weeks. Infection occurred in 3 cases. Delayed unions were observed in 4 cases. A non union occurred in 1 case of type IIIC. A mal union was observed in 1 case of type IIIB. 1 case of grade IIIC had the compartmental syndrome. No case had any implant failure (nail / screw breakage), or deep vein thrombosis.Conclusion: We conclude that the unreamed intramedullary nailing in cases of open fractures of the tibia, with an early soft tissue coverage, results in a faster soft tissue and bony healing, an easier soft tissue coverage, a better biomechanical stability and early rehabilitation and infection rates as comparable to those which are seen with other methods.
机译：背景（背景）：胫骨干是开放性骨折最常见的部位之一。骨骼稳定和软组织治疗开放性骨折的具体方法仍然是整形外科创伤学界争论的话题。目的：评估胫骨开放性骨折（尤其是在印度情况下）的髓内钉治疗结果。设计：一项观察性描述性研究，于2006年至2010年在一家三级医院进行。材料与方法：前瞻性研究针对30例患有Gustilo和Anderson I，II和III级持续性开放性骨折的病例进行，在必要时彻底清创并闭合伤口，并进行缝合，外侧皮肤释放，厚度均匀的皮肤移植术和肌蒂蒂皮瓣修复术，对这些患者进行一次髓内互锁钉固定。所有患者均接受了至少两年的随访。统计分析：采用描述性统计和Fisher氏精确检验。结果：在全部30例中，I级为10例，II级为7例，II级为3例。 IIIA级，七个为IIIB级，三个为IIIC级。动态化处理了9例。 I级患者平均工会时间为16.0周，II级患者平均为18.3周，A级患者为23.6周，B级患者为28.4周，B级为32周在III C级案件中。参加工会的平均时间为20.7周。 3例发生感染。观察到延迟工会4例。 1例IIIC型患者发生了非联合。在1例IIIB型患者中观察到了恶性结合。 1例IIIC级有隔室综合征。没有病例发生任何植入物失败（指甲/螺钉断裂）或深静脉血栓形成。结论：我们得出结论，在胫骨开放性骨折的情况下，未加髓膜的髓内钉，早期有软组织覆盖，可导致较快的软组织和与其他方法相比，骨愈合，软组织覆盖更容易，生物力学稳定性更好，早期康复和感染率更高。

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