钢板联合皮质外骨桥技术治疗肱骨干骨折术后萎缩性骨不连

发布时间：2018-05-06 18:50

本文选题：肱骨干骨折 + 萎缩性骨不连　；参考：《中国修复重建外科杂志》2017年01期

【摘要】：目的探讨锁定加压钢板联合皮质外骨桥技术治疗肱骨干骨折术后萎缩性骨不连的临床疗效。方法 2006年11月—2015年6月,采用锁定加压钢板联合皮质外骨桥技术治疗肱骨干骨折术后萎缩性骨不连患者17例。男11例,女6例;年龄24~63岁,平均38.2岁。致伤原因:交通事故伤13例,跌落伤3例,重物砸伤1例。受伤至该次入院前接受手术治疗1次7例,2次5例,3次4例,4次1例。骨折距该次入院时间为10~76个月,平均22.6个月。术后依据Neer肩关节评分标准和Mayo肘关节评分标准评价肩、肘关节功能。结果术后切口均Ⅰ期愈合,2例出现桡神经损伤症状。17例均获随访,随访时间15~60个月,平均27.3个月。X线片示骨不连均达骨性愈合,无畸形愈合,愈合时间10~41周,平均17.6周。移植髂骨板与肱骨皮质结合良好,无骨板、螺钉松动移位,术后6~8周桥接骨板与断端开始骨重建迹象,逐渐形成皮质外骨桥。末次随访时,Neer肩关节功能评分为72~96分,平均83.36分;获优10例,良5例,可2例,优良率88.24%。Mayo肘关节功能评分为68~100分,平均86.52分;获优11例,良3例,可3例,优良率82.35%。结论采用锁定加压钢板联合皮质外骨桥技术治疗肱骨干骨折术后萎缩性骨不连,既能够增加骨断端稳定性,又能实现良好的成骨和重建作用,疗效满意。
[Abstract]:Objective to investigate the clinical effect of locking compression plate combined with cortical bone bridge in the treatment of atrophic nonunion after humeral shaft fracture. Methods from November 2006 to June 2015, 17 patients with atrophic nonunion after humeral shaft fracture were treated with locking compression plate combined with cortical bone bridge. There were 11 males and 6 females, aged 2463 years (mean 38.2 years). The causes of injury were: 13 cases of traffic accident, 3 cases of falling injury and 1 case of heavy object injury. Before the injury, 7 cases were treated with operation once, 2 times, 5 times, 3 times, 4 times, 4 times, 1 case. The length of the fracture was 10 ~ 76 months (mean 22.6 months). The function of shoulder and elbow was evaluated according to Neer and Mayo. Results two cases of radial nerve injury were followed up. The follow-up time was 15 ~ 60 months (mean 27.3 months). X ray film showed that the nonunion was bony union and no malunion. The healing time was 1041 weeks (average 17.6 weeks). The graft iliac bone plate combined well with the humerus cortex, without bone plate, screw loosening and displacement. The graft bone plate and broken end began to reconstruct at 6 ~ 8 weeks after operation, and the external cortical bone bridge was gradually formed. At the last follow-up, Neer's shoulder function score was 720.96 (mean 83.36), excellent 10 cases, good 5 cases, fair 2 cases, excellent and good rate 88.24%.Mayo score 68 ~ 100, average 86.52 points, excellent 11 cases, good 3 cases, fair 3 cases, excellent and good rate 82.35%. Conclusion the treatment of atrophic nonunion with locking compression plate combined with external cortical bone bridge technique can not only increase the stability of the broken end of the bone, but also achieve good osteogenesis and reconstruction. The curative effect is satisfactory.
【作者单位】：蚌埠医学院第一附属医院骨科组织移植安徽省重点实验室;
【基金】：安徽省高校省级自然科学研究重点项目(KJ2016A870)~~
【分类号】：R687.32

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