Verma Rahul, Sharma Pulak, Gaur Sanjiv
Department of Orthopaedics, Gandhi Medical College, Bhopal, M.P., India.
Department of Orthopaedics, Gandhi Medical College, Bhopal, M.P., India.
Injury. 2017 Aug;48 Suppl 2:S23-S26. doi: 10.1016/S0020-1383(17)30490-4.
Non-union following interlocking nailing is a troubling complication in treatment of shaft femur fractures. There is no clear consensus on the treatment of this problem. This research was undertaken to study the role of augmentation plating combined with exchange nailing in such cases.
A prospective clinical study was undertaken from January 2010 to December 2015. Patients with aseptic femoral shaft non-union, with or without implant failure following intramedullary nailing were included in the study. Augmentation plating combined with Exchange Nailing with a 4.5mm LCP was done.
Fifteen patients (nine male and six female) with an average age of 43.7 years (range 18-67 years) were treated. Average timing from the first surgery was 7.3 months. Complete clinical and radiological union was achieved in all cases in a mean duration of 5.2 months. Average duration of follow up was 12.6 months. All the patients retained the preoperative hip and knee range of motion till the last follow up.
Augmentation plating combined with exchange nailing in non-unions following intramedullary nailing of femur shaft fractures is a reasonably good and effective procedure with a very high success rate.
交锁髓内钉固定术后骨不连是股骨干骨折治疗中一个棘手的并发症。对于该问题的治疗尚无明确的共识。本研究旨在探讨增强钢板联合更换髓内钉在这类病例中的作用。
2010年1月至2015年12月进行了一项前瞻性临床研究。纳入髓内钉固定术后发生无菌性股骨干骨不连且有或无植入物失败的患者。采用4.5mm锁定加压钢板进行增强钢板联合更换髓内钉手术。
共治疗15例患者（9例男性，6例女性），平均年龄43.7岁（范围18 - 67岁）。距首次手术的平均时间为7.3个月。所有病例均在平均5.2个月的时间内实现了完全的临床和影像学愈合。平均随访时间为12.6个月。直至最后一次随访，所有患者均保留了术前髋关节和膝关节的活动范围。
增强钢板联合更换髓内钉治疗股骨干骨折髓内钉固定术后骨不连是一种相当良好且有效的方法，成功率非常高。
