股骨干髓内钉固定失败：切开复位并在原位使用钢板加强髓内钉。
Failed intramedullary nailing of femur: open reduction and plate augmentation with the nail in situ.
机构信息
Department of Orthopedics and Trauma Surgery, Assiut University Hospitals, 71111, Assiut, Egypt.
出版信息
Int Orthop. 2011 Jul;35(7):1089-92. doi: 10.1007/s00264-010-1192-4. Epub 2011 Jan 11.
Abstract
METHODS
Fourteen patients with aseptic fractures that failed to unite after intramedullary nailing (IMN) of the femur were treated by augmentation of fixation by dynamic compression plate (DCP) with the nail in situ. In six of them that had axial or rotational malalignment, direct reduction of the bone fragments and plating were done. Iliac bone grafting was performed in nine cases, when there were gaps between the fragments and in atrophic non-unions. Patients were followed-up for an average of 26 months.
RESULTS
All patients had radiological union in an average of 4.3 months with an improvement in alignment, range of motion and shortening.
CONCLUSIONS
For failed IMN of the femur, augmentation of fixation by compression plate, with the nail in situ, is a good line of treatment. In cases with malalignment, correction was possible followed by plate augmentation.
摘要
方法
对 14 例股骨髓内钉固定后发生无菌性骨折不愈合的患者，采用原位钉动力加压钢板（DCP）固定增强来治疗。其中 6 例存在轴向或旋转对线不良的患者，直接进行骨碎片复位和钢板固定。9 例存在骨碎片间隙和萎缩性骨不连的患者进行了髂骨植骨。患者平均随访 26 个月。
结果
所有患者平均在 4.3 个月时获得影像学愈合，对线、活动度和短缩均得到改善。
结论
对于股骨髓内钉固定失败的病例，原位钉动力加压钢板固定增强是一种较好的治疗方法。对线不良的病例，可以先进行纠正，然后再进行钢板增强。
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