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采用伊利扎洛夫骨延长术治疗复杂股骨骨折不愈合的结果

Outcome of complex non-unions of femoral fractures managed with Ilizarov method of distraction osteogenesis.

作者信息

Bakhsh Karim, Zimri Faridullah Khan, Mohammad Eid, Saaiq Muhammad

机构信息

Dr. Karim Bakhsh, FCPS. Department of Orthopedics, Civil Hospital, Bolan Medical College, Quetta, Pakistan.

Dr. Faridullah Khan Zimri, FCPS. Department of Orthopedics, NIRM, Islamabad, Pakistan.

出版信息

Pak J Med Sci. 2019 Jul-Aug;35(4):1055-1059. doi: 10.12669/pjms.35.4.244.

Abstract

OBJECTIVE

To evaluate the management outcome of complex non-union of femoral fractures with Ilizarov method in terms of bone union, functional results and any complications.

METHODS

This case series study was carried out at the Departments of Orthopedic Surgery, National Institute of Rehabilitation Medicine (NIRM), Islamabad and Civil hospital, Quetta over a period of three and half years, January 1, 2015 to June 30,2018.

RESULTS

There were 50 patients in the study. There were 48(96%) males and 2(4%) females. The ages ranged between 17-54 years with a mean of 33.58±8.9 years. As per ASAMI criteria, the bone results were excellent in 17(34%), good in 30(60%), fair in 1(2%) and poor in 2(4%) patients. The functional results were excellent in 15(30%), good in 24(48%), fair in 8(16%) and poor in 3(6%). The bone union rate was 98% whereas infection eradication rate was 94%. The most frequent complications were pin tract infection affecting 80% patients, knee stiffness 60% patients and K-wires loosening 20% patients.

CONCLUSION

The Ilizarov method provides an effective solution to address the complex non-union of femur fractures. It helps to ensure fracture healing, eradicates infection and provides good functional outcome. The attended complications are mild to moderate and manageable with conservative means.

摘要

目的

从骨愈合、功能结果及任何并发症方面评估采用伊里扎洛夫方法治疗复杂股骨骨折不愈合的治疗效果。

方法

本病例系列研究于2015年1月1日至2018年6月30日在伊斯兰堡国家康复医学研究所(NIRM)骨科及奎达市民医院进行,为期三年半。

结果

本研究中有50例患者。其中男性48例(96%),女性2例(4%)。年龄范围在17至54岁之间,平均年龄为33.58±8.9岁。根据ASAMI标准,17例(34%)患者的骨结果为优,30例(60%)为良,1例(2%)为中,2例(4%)为差。功能结果方面,15例(30%)为优,24例(48%)为良,8例(16%)为中,3例(6%)为差。骨愈合率为98%,感染清除率为94%。最常见的并发症是针道感染,影响80%的患者;膝关节僵硬,影响60%的患者;克氏针松动,影响20%的患者。

结论

伊里扎洛夫方法为解决复杂股骨骨折不愈合提供了有效的解决方案。它有助于确保骨折愈合,清除感染,并提供良好的功能结果。出现的并发症为轻至中度,采用保守方法可处理。

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