股骨骨不连的钢板增强术：仅仅是一种挽救手段吗？
Plate augmentation for femoral nonunion: more than just a salvage tool?
作者信息
Chiang J C, Johnson J E, Tarkin I S, Siska P A, Farrell D J, Mormino M A
机构信息
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Department of Orthopaedic Surgery, Division of Orthopaedic Trauma, University of Pittsburgh Medical Center, Kaufmann Building, Suite 911, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA.
出版信息
Arch Orthop Trauma Surg. 2016 Feb;136(2):149-56. doi: 10.1007/s00402-015-2365-9. Epub 2015 Dec 8.
OBJECTIVE
The aim of the current study was to determine whether plate augmentation was a successful treatment algorithm for selected femoral nonunions initially managed with intramedullary nailing.
MATERIALS AND METHODS
A total of 30 femoral nonunion cases were managed using the plate augmentation strategy with 13 primary cases and 17 multi-operated femurs (avg 2.8 ineffective procedures). Adjunctive strategies included autologous bone grafting and/or BMP for atrophic/oligotrophic and bone defect cases. Deformity correction was performed when required.
RESULTS
Osseous union occurred in 29 of 30 cases. One multi-operated case with bone defect and prior infection required repeat autologous grafting prior to union.
CONCLUSION
Plate augmentation should be added to the armamentarium for management of selected femoral nonunion that have failed initial intramedullary nailing.
目的
本研究的目的是确定钢板增强术对于最初采用髓内钉治疗的特定股骨骨不连是否是一种成功的治疗方法。
材料与方法
共30例股骨骨不连病例采用钢板增强术治疗，其中13例为初次病例，17例为多次手术的股骨（平均2.8次无效手术）。辅助策略包括自体骨移植和/或骨形态发生蛋白用于萎缩性/营养不良性和骨缺损病例。必要时进行畸形矫正。
结果
30例中有29例发生骨愈合。1例多次手术且有骨缺损和既往感染的病例在愈合前需要再次进行自体移植。
结论
对于最初髓内钉治疗失败的特定股骨骨不连，应将钢板增强术纳入治疗手段。
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