Patel V R, Menon D K, Pool R D, Simonis R B
Rowley Bristow Orthopaedic Unit, St Peter's Hospital, Chertsey, England, UK.
J Bone Joint Surg Br. 2000 Sep;82(7):977-83. doi: 10.1302/0301-620x.82b7.10180.
We used the Ilizarov circular external fixator to treat 16 patients with persistent nonunion of the diaphysis of the humerus despite surgical treatment. All patients had pain and severe functional impairment of the affected arm. In ten, nonunion followed intramedullary nailing. We successfully treated these by a closed technique. The nail was left in place and the fracture compressed over it. The fractures of the other six patients had previously been fixed by various methods. We explored these nonunions, removed the fixation devices and excised fibrous tissue and dead bone before stabilising with the Ilizarov fixator. In five patients union was achieved. Bone grafting was not required. In the single patient in whom treatment failed, there had been a severely comminuted open fracture. All except one patient had reduction of pain, and all reported an improvement in function.
我们使用Ilizarov环形外固定器治疗16例尽管接受了手术治疗但仍存在肱骨干持续性骨不连的患者。所有患者均有疼痛且患侧手臂存在严重功能障碍。其中10例骨不连发生在髓内钉固定术后。我们通过闭合技术成功治疗了这些患者。保留髓内钉，在其上对骨折部位进行加压。其他6例患者的骨折此前曾采用多种方法固定。我们对这些骨不连部位进行探查，移除固定装置，切除纤维组织和死骨，然后用Ilizarov固定器进行稳定固定。5例患者实现了骨愈合，无需进行骨移植。在治疗失败的1例患者中，曾发生严重粉碎性开放性骨折。除1例患者外，所有患者疼痛均减轻，且均报告功能有所改善。
