带锁钢板治疗交锁髓内钉固定后无菌性骨不连。

Treatment of aseptic nonunion after intramedullary nailing fixation with locking plate.

机构信息

Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, China.

出版信息

Orthop Surg. 2009 Nov;1(4):258-63. doi: 10.1111/j.1757-7861.2009.00040.x.

DOI:10.1111/j.1757-7861.2009.00040.x

PMID:22009872

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6583635/

Abstract

OBJECTIVE

To evaluate the safety and efficacy of locking plate combined with bone grafting in the treatment of aseptic nonunion following intramedullary nailing fixation of fractures of the long bones.

METHODS

Thirty-eight consecutive patients treated in our hospital between January 2004 and December 2006 were included in this retrospective study. The nonunions included 20 femurs, 15 tibias, and 3 humeri. The duration of non-union ranged from 6 to 84 months and 21 (55.3%) of them were located around the metaphysis of the affected long bones. There were 12 women and 26 men with a mean age of 39.2 years (range, 9-70 years). Locking plate combined with bone grafting was the procedure chosen to treat every case of nonunion in this series. The clinical outcomes were evaluated.

RESULTS

All patients were followed up for 6-20 months (average 11.6 months). After locking plate fixation combined with bone grafting, union was achieved in all cases, the average healing time being 5.3 months (range, 4-8 months). Infection of the superficial incision occurred in three cases (7.9%) and delayed healing of the incision in one case, all of which healed with no further complications. The function of the adjacent joints was excellent to good in 30 patients (78.9%), fair in 7 (18.4%) and poor in 1 (2.6%) after follow-up.

CONCLUSION

Locking plate fixation combined with bone grafting is a highly effective treatment for aseptic nonunions of the long bones after intramedullary nailing fixation, especially in the case of metaphyseal nonunion.

摘要

目的

评估交锁钢板联合植骨治疗交锁髓内钉固定长骨骨折后无菌性骨不连的安全性和疗效。

方法

本回顾性研究纳入了 2004 年 1 月至 2006 年 12 月期间在我院接受治疗的 38 例连续患者。不愈合包括 20 例股骨、15 例胫骨和 3 例肱骨。不愈合时间为 6-84 个月，其中 21 例（55.3%）位于受影响长骨的干骺端附近。患者中女性 12 例，男性 26 例，平均年龄 39.2 岁（范围 9-70 岁）。本系列所有病例均选择采用交锁钢板联合植骨治疗骨不连。评估了临床结果。

结果

所有患者均获得随访 6-20 个月（平均 11.6 个月）。在采用交锁钢板固定联合植骨治疗后，所有病例均达到愈合，平均愈合时间为 5.3 个月（范围 4-8 个月）。3 例（7.9%）出现浅表切口感染，1 例切口愈合延迟，所有患者均治愈，无进一步并发症。随访时，30 例（78.9%）患者的相邻关节功能为优或良，7 例（18.4%）为可，1 例（2.6%）为差。