Orthopaedic Department, Ain Shams University, Cairo, Egypt.
Ann Acad Med Singap. 2009 Dec;38(12):1090-4.
The failure of a humeral fracture to unite after surgical treatment may be due to many factors. When there are additional complications of infection, treatment by conventional methods of internal fixation becomes very difficult.
We treated 8 infected non-union of diaphyseal fracture of the humerus by the Orthofix external fixator. All had previous surgical treatment. Non-union followed plating in 6 cases and in 2 cases after the external fixator. All patients had pain, at least one sinus discharging pus and severe functional impairment of the affected arm. There were 6 men and 2 women with a mean age 40.6 years.
Bone union was achieved in all cases. The mean time to union was 4.5 months (range, 2 to 8). Patients expressed high levels of satisfaction with the outcome, despite relatively modest improvement in pain and function, mainly because of long standing infection and intractable non-union. There were no major pin tract problems requiring the removal of the Schanz screws. Radial nerve palsy developed in 1 patient who recovered spontaneously. No patient required an additional bone grafting procedure.
The use of the Orthofix external fixator without bone grafting was successful in the treatment of infected non-union of the humeral shaft. It shortened the duration of hospitalisation and immobilisation with moderate functional recovery.
肱骨骨折手术后不愈合可能是由多种因素引起的。当合并感染等并发症时，传统的内固定治疗方法变得非常困难。
我们采用 Orthofix 外固定架治疗 8 例感染性肱骨干骨折不愈合患者。所有患者均有既往手术史，其中 6 例为钢板内固定术后，2 例为外固定架术后。所有患者均有疼痛，至少 1 个窦道有脓性分泌物，患肢功能严重受损。男性 6 例，女性 2 例，平均年龄 40.6 岁。
所有患者均获得骨性愈合，平均愈合时间为 4.5 个月（范围 2 至 8 个月）。尽管疼痛和功能改善程度相对较小，主要是由于长期感染和难治性不愈合，但患者对治疗结果表示非常满意。无患者出现需要取出斯氏针的主要针道问题。1 例患者发生桡神经麻痹，自行恢复。无患者需要额外植骨。
在不植骨的情况下使用 Orthofix 外固定架治疗感染性肱骨干骨折不愈合是成功的，它缩短了住院和固定时间，功能恢复适度。
