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[初次锁定髓内固定后股骨干骨折不愈合的钢板及异种骨板治疗]

[Treatment of nonunion of femoral shaft fracture after initial locked intramedullary fixation with plate and xenogenic bony plate].

作者信息

Dai Jin-zhang, Chen Chang-qing, Mao Si, Wang Yao-sheng, Zhou Ying

出版信息

Zhongguo Gu Shang. 2015 Feb;28(2):174-6.

Abstract

OBJECTIVE

To investigate the clinical effects of plate and xenogenic bony plate for the treatment of nonunion of femoral shaft fracture after initial fixation with locked intramedullary nailing.

METHODS

From February 2006 to June 2013, 21 cases with nonunion of femoral shaft fracture after initial fixation with locked intramedullary nailing were treated with femoral plate and contralateral xenogenic bony plate. There were 12 males and 9 females with an average age of 34.8 years old (ranging from 18 to 62 years). The time of nonunion was 9 to 18 months (averaged 12.8 months). The clinical outcomes of the treatment were evaluated by Merchan assessment.

RESULTS

All of the patients were primary healing, and on complications such as infection,fat embolism, internal fixation breaking or rotational deformity, shortening were occurred. All the cases were followed up for 13.2 months (ranging from 8 to 24 months). Nineteen cases were bone healed,the time of union averaged 6.2 months (ranging from 4 to 9 months). Two cases appeared delayed union and gained bony union after 7 to 13 months' observation. According to the criterion of Merchan,the results were excellent in 13 cases, good in 6 cases, poor in 2 cases.

CONCLUSION

Treatment of nonunion of femoral shaft fracture after initial locked intramedullary fixation with plate and xenogenic bony plate has advantages of high curative rate and low complications, good postoperative function recovery, it is a reliable treatment to elevate the stability of fixation and promote the osteogenesis.

摘要

目的

探讨钢板及异种骨板治疗锁定髓内钉初次固定后股骨干骨折不愈合的临床效果。

方法

2006年2月至2013年6月,对21例锁定髓内钉初次固定后股骨干骨折不愈合患者采用股骨钢板及对侧异种骨板治疗。其中男12例,女9例,平均年龄34.8岁(18~62岁)。骨折不愈合时间为9~18个月(平均12.8个月)。采用Merchan评估法评价治疗的临床效果。

结果

所有患者均一期愈合,未发生感染、脂肪栓塞、内固定断裂或旋转畸形、短缩等并发症。所有病例均随访13.2个月(8~24个月)。19例骨折愈合,愈合时间平均6.2个月(4~9个月)。2例出现延迟愈合,观察7~13个月后获得骨性愈合。根据Merchan标准,结果为优13例,良6例,差2例。

结论

采用钢板及异种骨板治疗锁定髓内钉初次固定后股骨干骨折不愈合,具有治愈率高、并发症低、术后功能恢复良好的优点,是提高固定稳定性、促进成骨的可靠治疗方法。

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