摘要
目的:探讨双钢板结合髂骨植骨治疗髓内钉术后股骨骨不连的临床效果。方法:2008年12月至2017年12月应用双钢板结合自体髂骨植骨治疗髓内钉术后股骨骨不连患者11例,男10例,女1例;年龄35~62岁;骨折至骨不连时间12~20个月。根据Judet分类法分型:萎缩型骨不连8例,增生型骨不连3例。术后定期随访,记录患者骨折愈合时间、负重活动时间及并发症等情况,观察双钢板固定联合髂骨植骨对股骨干骨折术后骨不连的修复效果。结果:11例患者均获得骨性愈合,随访时间12~22个月。手术切口均Ⅰ期愈合,手术时间70~130 min,出血量180~350 ml。术后2例出现膝关节僵硬,经CPM机被动锻炼2周后恢复;1例出现髂骨供骨区疼痛,3个月后缓解。骨折愈合时间24~40周;患者完全负重活动时间14~32周。末次随访时SF-36生活质量评分:躯体疼痛70~82分,活动评分70~82分,社会功能72~83分,总体健康72~82分。随访结束时,患者均未发生患肢短缩、感染、切口愈合不良、内固定物失效(断裂、松动)等并发症。结论:采用双钢板结合自体髂骨植骨,是治疗髓内钉术后股骨骨不连的有效治疗方法,能获得满意的临床愈合结果。
Objective:To investigate the clinical effect of double plate combined with iliac bone graft in the treatment of femoral nonunion after intramedullary nailing.Methods:From December 2008 to December 2017,double plate combined with autogenous iliac bone graft was used to treat femoral nonunion after intramedullary nailing.There were 11 cases,including 10 males and 1 female,aged 35 to 62 years,and the time from fracture to nonunion was 12 to 20 months.According to Judet classification,there were 8 cases of atrophic nonunion and 3 cases of proliferative nonunion.Regular follow-up was conducted after operation to record the fracture healing time,load-bearing activity time and complications,and to observe the repair effect of double plate fixation combined with iliac bone graft on nonunion after femoral shaft fracture operation.Results:All patients were followed up for 12 to 22 months.The operation time was 70 to 130 min and the blood loss was 180 to 350 ml.After operation,2 cases had knee stiffness,which recovered after passive exercise with CPM machine for 2 weeks;1 case had pain in iliac bone donor area,which was relieved after 3 months.The time of fracture healing was 24 to 40 weeks,and the time of complete weight-bearing activity was 14 to 32 weeks.SF-36 quality of life score at the final follow-up:body pain 70 to 82,activty 70 to 82,social function 72 to 83,the overall health 72 to 82.At the end of the follow-up,there were no complications such as limb shortening,infection,poor wound healing,internal fixation failure(fracture,loosening).Conclusion:It is an effective method to treat nonunion of femur after intramedullary nailing by using double plate combined with autogenous iliac bone graft.
作者
孙振国
翁伟
杨红航
张占丰
闵继康
SUN Zhen-guo;WENG Wei;YANG Hong-hang;ZHANG Zhan-feng;MIN Ji-kang(Department of Orthopaedics,the First People’s Hospital of Huzhou,Osteoporotic Osteopathy Prevention and Treatment Center in Northern Zhejiang,the First Affiliated Hospital of Huzhou Normal University,Huzhou313000,Zhejiang,China)
出处
《中国骨伤》
CAS
CSCD
2021年第3期288-292,共5页
China Journal of Orthopaedics and Traumatology
基金
浙江省基础公益研究计划(编号:LGF20H060009)。
关键词
股骨骨折
骨折固定术
内
骨移植
骨折
不愈合
Femoral fractures
Fracture fixation,internal
Bone transplantation
Fractures,ununited
