Garnavos Christos
Orthopaedic Department of "Evangelismos" General Hospital, 45 Ipsilantou St, Athens 10676, Greece.
Injury. 2017 Jun;48 Suppl 1:S76-S81. doi: 10.1016/j.injury.2017.04.022. Epub 2017 May 6.
Failure of bone healing after intramedullary nailing of a diaphyseal long bone fracture is a severe complication that requires an effective management to ensure the best chances for successful bone-union and termination of a long period of incapacity and morbidity for the sufferers. Traditional procedures require removal of the existing nail and re-fixation with wider nail, plate or external fixation constructs. The concept that bone union can be obtained with the existing nail in situ is gaining popularity as its removal adds trauma and potential complications and prolongs the operating time. This article reviews all techniques that have been proposed for the management of aseptic diaphyseal long bone non-unions that stimulate bone healing without removing the existing nail.
骨干长骨骨折髓内钉固定后骨愈合失败是一种严重的并发症，需要有效的处理措施，以确保获得成功骨愈合的最佳机会，并使患者长时间的无行为能力和发病状态得以终结。传统的方法需要取出现有的髓内钉，并用更粗的髓内钉、钢板或外固定架重新固定。由于取出髓内钉会增加创伤和潜在并发症，并延长手术时间，因此在原位使用现有髓内钉实现骨愈合的理念越来越受到欢迎。本文综述了所有已提出的用于处理无菌性骨干长骨不愈合的技术，这些技术可在不取出现有髓内钉的情况下促进骨愈合。
