Zhang Wei, Zhang Zhuo, Li Jiantao, Zhang Licheng, Chen Hua, Tang Peifu
Department of Orthopedic Surgery, General Hospital of Chinese People's Liberation Army, 28 Fu-Xing Road, Beijing, 100853, People's Republic of China.
J Orthop Surg Res. 2018 Nov 20;13(1):295. doi: 10.1186/s13018-018-1002-z.
By comparing clinical outcomes between dual plating (DP) and exchange nailing with augmentation plating (EN/AP), we aimed to provide better treatment strategies for femoral shaft non-union.
We retrospectively reviewed 30 patients with aseptic femoral shaft non-union at our level 1 trauma center between January 2014 and January 2017. All patients underwent a one-stage, definitive revision procedure, including DP for 16 patients and EN/AP for 14 patients. Perioperative surgical trauma, fracture healing, complications, and the time to return to work were evaluated.
Twenty-nine patients achieved fracture healing. In the EN/AP group, the fracture healing rate was 100%, the healing time was 5.7 ± 1.7 months, and the time of return to work was 8.2 ± 2.9 months. In the DP group, the fracture healing rate was 94%, the healing time was 8.4 ± 4.1 months, and the time of return to work was 18.4 ± 10.3 months. In terms of fracture healing and return to work, the patients in the EN/AP group required less time than those in the DP group, and the differences were statistically significant (p = 0.024 and p < 0.01 respectively). Except for the length of the incision, the two groups showed no statistically significant differences in operative time, postoperative deformity, and complications.
Both EN/AP and DP are important surgical options for femoral shaft non-union. Compared to DP, EN/AP resulted in a shorter incision, faster fracture healing, and a shorter time to return to work.
ChiCTR-ORC-17014062.
通过比较双钢板固定（DP）与带锁髓内钉联合钢板固定（EN/AP）的临床疗效，我们旨在为股骨干骨不连提供更好的治疗策略。
我们回顾性分析了2014年1月至2017年1月期间在我们一级创伤中心接受治疗的30例无菌性股骨干骨不连患者。所有患者均接受一期确定性翻修手术，其中16例采用DP治疗，14例采用EN/AP治疗。评估围手术期手术创伤、骨折愈合情况、并发症以及恢复工作的时间。
29例患者实现骨折愈合。在EN/AP组中，骨折愈合率为100%，愈合时间为5.7±1.7个月，恢复工作时间为8.2±2.9个月。在DP组中，骨折愈合率为94%，愈合时间为8.4±4.1个月，恢复工作时间为18.4±10.3个月。在骨折愈合和恢复工作方面，EN/AP组患者所需时间比DP组少，差异具有统计学意义（分别为p = 0.024和p < 0.01）。除切口长度外，两组在手术时间、术后畸形和并发症方面无统计学显著差异。
EN/AP和DP都是股骨干骨不连的重要手术选择。与DP相比，EN/AP切口更短，骨折愈合更快，恢复工作时间更短。
ChiCTR-ORC-17014062。
