带锁髓内钉翻修与接骨板内固定治疗非干骺端股骨干骨不连
The treatment of nonisthmal femoral shaft nonunions with im nail exchange versus augmentation plating.
机构信息
Department of Orthopaedic Surgery, Aju University School of Medicine, Suwon, South Korea.
出版信息
J Orthop Trauma. 2010 Feb;24(2):89-94. doi: 10.1097/BOT.0b013e3181b8dafd.
OBJECTIVES
The purpose of this study was to compare the results between exchange nailing (EN) and augmentation plating (AP) with a nail left in situ for nonisthmal femoral shaft nonunion after femoral nailing.
DESIGN
: Retrospective data analysis, November 1996-March 2006.
SETTING
A level I trauma center.
PATIENTS
Eighteen patients with 18 nonisthmal femoral nonunions.
INTERVENTION
Seven patients with 7 fractures treated for nonisthmal femoral shaft nonunions after femoral nailing with EN and 11 patients with 11 fractures treated for nonisthmal femoral shaft nonunions after nailing with AP combined with bone grafting.
MAIN OUTCOME MEASURE
Union and complications.
RESULTS
Five nonunions in the EN group failed to achieve union (72% failure rate), whereas all 11 pseudarthroses in the AP group obtained osseous union. Fisher exact test showed a higher nonunion rate of EN compared with AP for nonisthmal femoral shaft nonunion (odds ratio, 6.5; P = 0.002).
CONCLUSIONS
AP with autogenous bone grafting may be a better option than EN for nonisthmal femoral nonunions.
目的
本研究旨在比较交锁钉（EN）和增强钢板（AP）联合保留原位钉治疗股骨干非典型部位骨不连的疗效。
设计
回顾性数据分析，1996 年 11 月至 2006 年 3 月。
地点
一级创伤中心。
患者
18 例非典型股骨骨不连患者。
干预措施
7 例患者采用 EN 治疗股骨干非典型部位骨不连，11 例患者采用 AP 联合植骨治疗股骨干非典型部位骨不连。
主要观察指标
愈合情况和并发症。
结果
EN 组 5 例骨不连未愈合（失败率 72%），AP 组 11 例假关节均获得骨性愈合。Fisher 确切概率法显示，EN 组非典型股骨骨不连的非愈合率高于 AP 组（比值比 6.5；P=0.002）。
结论
对于非典型股骨骨不连，AP 联合自体植骨可能是比 EN 更好的选择。
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