附加钢板单侧植骨治疗股骨干骨折髓内针固定术后肥大性骨不连的临床研究
发布时间：2019-07-07 06:59
【摘要】：目的:探讨附加钢板单侧植骨治疗股骨干骨折髓内针固定术后肥大性骨不连的植骨必要性及临床疗效。方法:2007年7月到2012年7月,我科收治股骨干骨折髓内针固定术后肥大性骨不连患者23例,失访3例,入选20例,其中男性12例,女性8例,年龄28岁-54岁(平均41.6岁)。骨折不愈合时间为股骨髓内针内固定术后9-28月,平均17.5个月。入选病例均采用保留原髓内针,附加锁定加压钢板一侧单皮质固定联合自体髂骨植骨治疗。术后7天开始部分负重,6个月后完全负重。术后1、3、6、12个月临床与影像学随诊。结果:20例患者术后全部获得随访,随访时间12-48个月(平均33.3个月)。20例患者骨折均获愈合,5例患者出现供骨区疼痛,1个月内症状缓解,无感染、内固定松动、断裂等并发症。骨折断端术后7个月出现明显骨痂,植骨侧骨痂出现时间平均7个月,非植骨侧骨痂出现时间平均7.8个月,9-16个月愈合牢固,平均愈合时间12.4个月。植骨侧与非植骨侧骨痂出现时间差异无统计学意义(Z=-1.302,P=0.1930.05)。结论:保留原髓内针,单侧附加钢板治疗股骨干骨折髓针内固定术后肥大性骨不连疗效确切,无需植骨,具有方法简单、损伤小、手术时间短、出血少、术后活动早等优点,是髓针内固定术后肥大性骨不连的有效治疗方法之一。
文内图片：
图片说明：病例一患者X线片
[Abstract]:Objective: to investigate the necessity and clinical effect of unilateral bone grafting with additional plate in the treatment of hypertrophic nonunion after intramedullary nail fixation. Methods: from July 2007 to July 2012, 23 patients with hypertrophic nonunion were treated in our department. There were 3 patients with hypertrophic nonunion after intramedullary nail fixation. 20 patients, including 12 males and 8 females, aged from 28 to 54 years (mean 41.6 years), were enrolled in the study. The nonunion time of fracture was 9-28 months after internal fixation of bone marrow needle, with an average of 17.5 months. All the selected cases were treated with preservation of the original intramedullary needle, single cortical fixation with locking compression plate and autogenous ilium bone grafting. Partial load began 7 days after operation and completely loaded 6 months later. Clinical and imaging follow-up was performed at 1, 3, 6, 12 months after operation. Results: all the 20 patients were followed up for 12 to 48 months (mean 33. 3 months). All the 20 patients were healed, 5 patients had pain in the donor area, symptoms relieved within 1 month, no infection, loosening of internal fixation, fracture and other complications. There were obvious eschar at 7 months after fracture, 7 months on average, 7.8 months on average, and 12.4 months on average on the non-graft side, and the average healing time was 12.4 months for 9 鈮，
本文编号：2511356
文内图片：
图片说明：病例一患者X线片
[Abstract]:Objective: to investigate the necessity and clinical effect of unilateral bone grafting with additional plate in the treatment of hypertrophic nonunion after intramedullary nail fixation. Methods: from July 2007 to July 2012, 23 patients with hypertrophic nonunion were treated in our department. There were 3 patients with hypertrophic nonunion after intramedullary nail fixation. 20 patients, including 12 males and 8 females, aged from 28 to 54 years (mean 41.6 years), were enrolled in the study. The nonunion time of fracture was 9-28 months after internal fixation of bone marrow needle, with an average of 17.5 months. All the selected cases were treated with preservation of the original intramedullary needle, single cortical fixation with locking compression plate and autogenous ilium bone grafting. Partial load began 7 days after operation and completely loaded 6 months later. Clinical and imaging follow-up was performed at 1, 3, 6, 12 months after operation. Results: all the 20 patients were followed up for 12 to 48 months (mean 33. 3 months). All the 20 patients were healed, 5 patients had pain in the donor area, symptoms relieved within 1 month, no infection, loosening of internal fixation, fracture and other complications. There were obvious eschar at 7 months after fracture, 7 months on average, 7.8 months on average, and 12.4 months on average on the non-graft side, and the average healing time was 12.4 months for 9 鈮，
本文编号：2511356
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