キュンチャー氏髄内釘固定法による長管状骨々折治療の研究

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タイトル別名
  • キュンチャー氏髄内釘固定法による長管状骨々折の研究
  • キュンチャー シズイナイクギ コテイホウ ニ ヨル チョウ カンジョウ コツコツセツ ノ ケンキュウ
  • Studies on Intramedullary Fixation of Fractures of the Long Bones with Kuentscher Nails
  • 原著
  • Original Article

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During a period of 5 years and 9 months from July, 1954 to 1958, intramedullary fixation of fractures of the long bones with Kuentscher nails was done on 66 patients (69 limbs) in our clinic. Statistical survey of the status of the treated bones more than 6 months following operation, made on 61 patients of whom we had net lost track, revealed the following result: excellent, 41 patients (67.2%); good, 13 patients (21.3%): fairly good, 4 patients (6.6%): and poor, 3 patients (4.9%). Strength tests made by the author on various kinds of intramedullary nails showed that in adults the No. 11 V-shaped nail of 22 A steel should be used for the femur, and the No. 9 V-shaped nail of 22 A steel for the tibia and humerus. As for the relative strength of nails of the same diameter, it was proved dynamically that the clover-leaf-shaped and heart- shaped nails (the latter being developed by the author) were superior to the three-wing-shaped and V-shaped nails. When a nail fitted the intramedullary cavity and the broken parts well, the patients could do without any auxilliary means of support, such as a sling, and could walk early in the postoperative period. It was shown that nails had no bad influence on callus formation, and that no sooner had the external callus developed than the intermediate callus was formed, when repair took place swiftly. They had no bad influence on general body condition and bone salts metabolism either. Although it was shown clinically that they facilitated an increase of the bone in longitudinal length when used in young persons, animal experiments showed that the nails, when kept in place over a long period, arrested the growth of the bone. The use of Kuentscher nails in young persons should, therefore, be avoided as much as possible. It was also shown that the use of Kuentscher nails would not necessarily be contraindicated in compound fracture.

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