摘要
目的髓内钉治疗四肢长管状骨骨折是临床普遍应用的方法,但由于种种原因造成部分患者交锁髓内钉治疗后骨不连的发生,文中探讨应用附加锁定加压钢板（locking compression plate,LCP）治疗髓内钉固定后肥大型骨不连的方法及疗效。方法应用交锁髓内钉治疗长骨骨折患者313例,其中12例出现肥大型骨不连,男7例,女5例,年龄25-54岁,平均36.6岁。骨折部位：肱骨3例,股骨4例,胫骨5例。从受伤到治疗骨不连平均时间为14.5个月。LCP置于骨干旁,用锁定螺钉作单皮质固定,骨折两端各用2-3枚螺钉。12例患者均作自体髂骨植骨。结果 12例患者术后随访8-22个月（平均14个月）,术后4-10个月（平均6个月）均出现骨性愈合,X线片显示,骨痂连续性生长过骨折线或骨折线模糊。12例患者均未出现感染内固定松动或断裂等并发症。结论附加LCP治疗髓内钉固定后骨不连,简单方便,手术创伤小,疗效确定,是治疗髓内钉固定后肥大型骨不连的有效方法。
Objective Intramedullary nailing is universally applied in the treatment of long bone fractures in the four limbs,but some patients thus treated may develop bone nonunion.This study was to investigate the methods and effects of locking compression plate（LCP） in unicortical fixation for treating hypertrophia bone nonunion after intramedullary nailing.Methods A total of 313 patients with long bone fractures were treated by intramedullary nailing,in whom 12 developed hypertrophia bone nonunion,including 7 males and 5 females aged 25-54（mean 36.6） years.Three of the cases occurred in the humerus,4 in the femur and 5 in the tibia.The average time from injury to LCP treatment was 14.5 months.The LCPs were placed beside the diaphysis,and the two ends were fixed with 2 or 3 locking screws.All the 12 patients received iliac bone graft and were followed up for 8-22（mean 14） months.Results X-ray imaging revealed bony callus at the broken ends of the fracture at 4-10（mean 6） months after surgery,but no such complications as infection and loosening or breaking of the inserts.Conclusion LCP,advantageous for its convenience,less invasiveness and definite efficacy,can be used for the treatment of hypertrophia bone nonunion following intramedullary nailing.
出处
《医学研究生学报》
CAS
2010年第11期1184-1186,共3页
Journal of Medical Postgraduates
关键词
锁定加压钢板
交锁髓内钉
长骨骨折
骨不连
Locking compression plate
Intramedullary nailing
Long bone fracture
Bone nonunion
