Saito Tomohiro, Matsumura Tomohiro, Nakashima Mitsuharu, Takeshita Katsushi
Department of Orthopedic Surgery, School of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke 329-0498, Japan.
Trauma Case Rep. 2020 Feb 22;26:100293. doi: 10.1016/j.tcr.2020.100293. eCollection 2020 Apr.
Infected non-union of subtrochanteric fractures is challenging to treat. We experienced two cases and had good clinical results. Treatment strategy comprised debridement without hesitation after considering later limb lengthening; insertion of the proximal lateral bone edge spike into the distal bone marrow cavity until achieving medial-side bony contact and holding good alignment to compensate for the medial-side bone loss, according to the modified Dimon method; and internal fixation with an angled plate in the decubitus position. The angle of the angled plate should be directed toward the abundant cancellous bone using preoperative computed tomography. Residual limb shortening after ORIF was improved by limb lengthening.
转子下骨折的感染性骨不连治疗具有挑战性。我们遇到了两例病例并取得了良好的临床效果。治疗策略包括：在考虑后期肢体延长后毫不犹豫地进行清创；根据改良的迪蒙方法，将近端外侧骨边缘骨钉插入远端骨髓腔，直至实现内侧骨接触并保持良好对线以补偿内侧骨缺损；以及在卧位使用角钢板进行内固定。应使用术前计算机断层扫描将角钢板的角度指向丰富的松质骨。切开复位内固定术后的肢体短缩通过肢体延长得到改善。
