新型胫骨分叉式交锁髓内钉的应用

Theapplicationofanewforkinterlockingintramedullarynailfortibialfracture新型胫骨分叉式交锁髓内钉的应用Methods方法•Forkintralockingintramedullarynail(FLN)•Grosse–Kempt(GK)•Rectanglenail(RN)•8-holeplante(8PT)•Plumblossomnail(PBN)•Endersnail(EN)•分叉式交锁髓内钉•GK钉（静力性交锁钉）•矩形钉•8孔钢板•梅花钉•Ender钉Comparison比较•Anti-compression•Anti-bending•Anti-torsion•Rigidity•FLN=GK•FLNRN,8PT,PBN,EN•抗轴向压缩•抗弯曲•抗扭转•强度Casereport病例汇报•Tibialfracture169cases•Follow3months147•Averagehealingperiod19.6weeks•Excellentrate96.5%•Fair1.3%•Failure2.2%•胫骨骨折169例•随访》3个月147例•平均骨折愈合时间19.6周•优良率96.5%•一般1.3%•差2.2%Complication并发症•Externalrotationdeformities5cases•Valgusdeformities4cases•Varusdeformities2cases•Shortening-displacements6cases•Painatthenail-entrypoint16cases•Infectionrate1.6%•Peronealnerveinjury1cases•Delayedpostoperativeinfection3cases•外旋畸形5例•外翻畸形4例•内翻畸形2例•短缩移位6例•膝关节进针点疼痛16例•感染率1.6%•腓总神经损伤1例•术后发生迟发感染3例Combinedandseperatedfigureofforknail分叉钉组合，分解图CaseX-ray病例X•胫骨中段骨折术前Casex-ray病例X•术后3天Casex-ray病例X•术后3个月Casex-ray病例X•术后1年Casex病例X（一钉两用）•胫骨下段骨折术前Casex病例X（一钉两用）•FLN固定Operationpath手术入路•Classicoperationpath•Newoperationpath•胫骨平台下方0.5-1CM处纵行劈开膑韧带•胫骨平台中点、前缘下方0.5CM以内该点偏离胫骨结节水平距离约0.5CM，恰巧位于中轴线上.(不切膑韧带）Conclusion结论•FLNisaneffectiveandconvenientimplanttotreattibialfracture•Inseverelycomminutedfractureanddistalshaftfracture,thedistalholecoundbeinsertedwithtwotransversescrewssimilartoGK,whichcanwidenitsindication•FLN是一种方便有效治疗胫骨骨折的方法、•对于严重胫骨粉碎性骨折和下段骨折者远端改以两枚横行锁钉，与GK钉相同，具有一钉两用，手术适应征广等特点ThankyouEveryone