[股骨内固定术后骨不连二次手术的合理性分析]

[Rationality analysis of the second operation for femoral nonunion with internal fixation].

作者信息

Jin Jun-wei, Zhao Gang

出版信息

Zhongguo Gu Shang. 2016 Jan;29(1):48-51.

PMID:27019897

Abstract

OBJECTIVE

To analyze rationality of internal fixation with original fixation in the second operation for femoral nonunion.

METHODS

A retrospective study was conducted to analyze the clinical data of 19 femoral nonunion patients treated by internal fixation with original fixation in the second operation since January 2009 to July 2014, including 14 males and 5 females with an average age of (43.63 ± 3.95) years old ranging from 18 and 75 years old. The original fixations involved plate fixation in 11 cases and interlocking intramedullary nail in 8 cases (including 3 cases of retrograde interlocking intramedullary nails). There were 13 cases of atrophic nonunion and 6 cases of hypertrophic nonunion in pathological classification. After second operation, the fracture healing time, Harris hip score and range of motion of the knee joint was recorded and compared with preoperative.

RESULTS

After the second operatioin, all patients were followed up for 6 to 30 months with an average of (18.67 ± 7.59) months. All patients got fracture healing, and the fracture radiological healing time was from 7 to 29 months with an average of (15.78 ± 4.97) months. Harris hip scores were improved from preoperative 62.37 ± 19.48 to postoperative 87.42 ± 8.86. The range of motion of the knee joint was improved from preoperative (52.16 ± 20.10)° to postoperative (96.32 ± 22.10)°.

CONCLUSION

It has a better clinical healing rate for using original fixation to treat femoral nonunions, and theoretically speaking it was rationality.

摘要

目的

分析股骨骨不连二次手术采用原内固定方式的合理性。

方法

回顾性分析2009年1月至2014年7月采用原内固定方式进行二次手术治疗的19例股骨骨不连患者的临床资料，其中男性14例，女性5例，平均年龄（43.63±3.95）岁，年龄范围18～75岁。原内固定方式中钢板固定11例，带锁髓内钉固定8例（其中逆行带锁髓内钉3例）。病理分型中萎缩性骨不连13例，肥大性骨不连6例。二次手术后记录骨折愈合时间、Harris髋关节评分及膝关节活动度，并与术前进行比较。

结果

二次手术后，所有患者均获随访6～30个月，平均（18.67±7.59）个月。所有患者骨折均愈合，骨折影像学愈合时间7～29个月，平均（15.78±4.97）个月。Harris髋关节评分由术前62.37±19.48提高至术后87.42±8.86。膝关节活动度由术前（52.16±20.10）°提高至术后（96.32±22.10）°。