带锁髓内钉固定术后肱骨难治性骨不连采用原位带钉锁定加压钢板植骨及肩人字石膏治疗：1例报告
Resistant Non-union of Humerus After Intramedullary Nailing Treated with Locking Compression Plate with Bone Grafting With Nail in Situ and Shoulder Spica: A Case Report.
作者信息
Singh Jagdeep, Kalia Anoop, Khatri Kavin, Dahuja Anshul
机构信息
Department of Orthopaedics, Guru Gobind Singh Medical, College and Hospital, Faridkot, Punjab, India.
出版信息
J Orthop Case Rep. 2017 Sep-Oct;7(5):80-83. doi: 10.13107/jocr.2250-0685.906.
INTRODUCTION
Humerus non-union is a challenging situation for the surgeon and devastating and morbid situation for the patient. Surgical approach to the humerus is demanding because of the complex neurovascular anatomy and especially when previous surgeries have been attempted.
CASE REPORT
We report a case of a young adult male who sustained a compound fracture of humerus shaft treated with intramedullary nailing followed by subsequent bone grafting and eventually landed up in non-union and was treated at our center by locking compression plate application with nail in situ with iliac crest autogenous bone graft followed by shoulder spica application.
CONCLUSION
Although humerus nailing is a valid therapeutic option for humeral shaft fractures, compression plating is considered the gold standard and non-union secondary to failed interlocking nailing is a challenging situation.
引言
肱骨不愈合对外科医生来说是一个具有挑战性的情况，对患者而言则是灾难性且病态的情况。由于肱骨复杂的神经血管解剖结构，尤其是在之前尝试过手术的情况下，对肱骨进行手术入路要求很高。
病例报告
我们报告一例年轻成年男性病例，其肱骨干发生开放性骨折，接受了髓内钉固定治疗，随后进行了骨移植，最终出现不愈合，并在我们中心接受治疗，采用锁定加压钢板原位固定并加用髓内钉，取自体髂骨移植，随后应用肩人字石膏。
结论
尽管髓内钉固定是肱骨干骨折的一种有效治疗选择，但加压钢板固定被认为是金标准，而交锁髓内钉固定失败继发的不愈合是一个具有挑战性的情况。
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