Feng Dong-Xu, Sun Liang, Feng Wei-Lou, Zhang Kun, Li Shu-Hao, Huang Wei, Zhu Yang-Jun, Zhao Zan-Dong
Department of Orthopaedics, Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China.
Department of Orthopaedics, Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China;
Zhongguo Gu Shang. 2019 Dec 25;32(12):1160-1164. doi: 10.3969/j.issn.1003-0034.2019.12.019.
To investigate the clinical results of locking compression plate combined with autologous iliac bone graft in the treatment of aseptic ulnar nonunion.
From March 2009 to July 2017, 22 patients with aseptic ulnar diaphyseal nonunion with complete follow-up data were treated with surgery, including 12 males and 10 females, aged from 16 to 58 (39.7±9.9) years old and ranging in course of disease from 10 to 192 (39.4±55.7) months. There were 15 atrophic nonunions, 5 hypertrophic nonunions and 2 synovial pseudo-articular nonunions. After debridement of the nonunion, locking compression plate was used to fix the nonunion and autogenous iliac bone graft was given. Bone healing rate, surgical complications and clinical results were evaluated.
All the patients were followed up, and the duration ranged from 13 to 42 months, with a mean of (22.5±8.2) months, and 1 patient did not heal. Visual analogue pain scores ranged from 0 to 3 (0.9±0.9). Pronation of forearm was 47 to 86 (69.0±14.7) degrees, supination was 35 to 85 (63.0±9.4) degrees, wrist flexion was 20 to 80 (51.0±10.2) degrees, wrist flexion was 32 to 88 (71.0±11.7) degrees, elbow flexion contracture was 0 to 25 (9.0±5.6) degrees, further flexion was 105 to 150 (134.0±13.9) degrees, and grip strength was 87% on the opposite side. According to the Anderson scoring system, 8 cases were excellent, 11 were satisfied, 2 were not satisfied, and 1 was failed.
LCP combined with autologous iliac bone graft can effectively treat aseptic ulna diaphyseal nonunion.
探讨锁定加压钢板结合自体髂骨移植治疗尺骨无菌性骨不连的临床效果。
选取2009年3月至2017年7月间22例有完整随访资料的尺骨干无菌性骨不连患者行手术治疗，其中男12例，女10例；年龄16～58岁，平均（39.7±9.9）岁；病程10～192个月，平均（39.4±55.7）个月。萎缩性骨不连15例，肥大性骨不连5例，滑膜假关节型骨不连2例。对骨不连处进行清创后，采用锁定加压钢板固定骨不连并给予自体髂骨移植。评估骨愈合率、手术并发症及临床效果。
所有患者均获随访，随访时间13～42个月，平均（22.5±8.2）个月，1例未愈合。视觉模拟疼痛评分0～3分，平均（0.9±0.9）分。前臂旋前47～86°，平均（69.0±14.7）°；旋后35～85°，平均（63.0±9.4）°；腕关节掌屈20～80°，平均（51.0±10.2）°；背伸32～88°，平均（71.0±11.7）°；肘关节屈曲挛缩0～25°，平均（9.0±5.6）°；进一步屈曲105～150°，平均（134.0±13.9）°；握力为健侧的87%。根据Anderson评分系统，优8例，良11例，可2例，差1例。
锁定加压钢板结合自体髂骨移植能有效治疗尺骨干无菌性骨不连。
