目的 评估阻挡钉在胫骨远端骨折髓内钉内固定使用中的辅助作用。方法 回顾性研究55例胫骨远端骨折经髓内钉固定病例的临床资料， 其中单纯髓内钉固定24例， 髓内钉结合阻挡钉固定31例， 将两种术式病例资料进行分组分析。结果 两组患者随访时间6～15个月， 平均9个月。髓内钉结合阻挡钉组较单纯髓内钉组手术时间明显缩短( t=2.57， P<0.05)， 术后骨折再移位发生率两组间差异无统计学意义( P>0.05)， 两组骨性愈合时间差异无统计学意义( t=0.606， P>0.05)。髓内钉结合阻挡钉组末次随访踝关节评分优良率高于单纯髓内钉组( χ²=7.78， P<0.05)。结论 阻挡钉技术在胫骨远端骨折髓内钉内固定中可起到促进和维持骨折复位、加强髓内钉内固定后骨折稳定性的作用， 并可为肢体功能恢复提供有利条件。

Objective To assess the clinical effects of blocking screws in the internal fixation with intermedullary nails on distal tibial fractures. Methods The clinical data of 55 cases of distal tibial fractures treated by intermedullary nails were retrospectively studied. These cases were divided into two groups: 24 cases who were treated by intramedullary nails simply and 31 cases who were treated by blocking screws with intramedullary nails. The clinical data of two groups were statistically analyzed. Results These cases were followed up for 6 to 15 months, with an average of 9 months. The group of blocking screws with intramedullary nails got shorter operation duration ( t=2.57, P<0.05). There was no statistically significant difference in the rate of re-dislocation between the two groups( P>0.05)There was no statistically significant difference in the fracture healing time between the two groups( t=0.606, P>0.05).The group of blocking screws with intramedullary nails got higher grade of ankle joint function( χ²=7.78, P<0.05).Conclusions Blocking screw technique has the effects of improving and maintaining the fracture reduction in the internal fixation with intramedullary nails in distal tibial fractures, and strengthens the stability of fractures after internal fixation with intermedullary nails.It also provides benefits for limb function recovery.