Department of Orthopaedics, the 909th Hospital, School of Medicine, Xiamen University, Zhangzhou, China.
J Int Med Res. 2023 Jul;51(7):3000605231187945. doi: 10.1177/03000605231187945.
This study was performed to evaluate the effectiveness of intramedullary nailing and a lateral locking plate combined with the reamer-irrigator-aspirator (RIA) bone grafting technique for resistant distal femoral nonunion.
This retrospective observational study was performed from January 2018 to December 2021 and involved five patients who presented with resistant distal femoral nonunion despite undergoing several surgeries. They were treated with intramedullary nailing and a lateral locking plate combined with the RIA bone grafting technique. Postoperative follow-up was performed to observe the healing time, and functional outcomes were evaluated using the Lower Extremity Functional Scale (LEFS).
After the patients had been monitored for a mean of 17.9 months, complete bone healing was observed in every patient (mean healing time of 4.8 months). Postoperative wound failure in an older patient was successfully treated with resuturing and nutritional assistance. At the last follow-up, the mean LEFS score was 71.2/80 and the mean knee flexion was 109 degrees.
Our study demonstrates that combining intramedullary nailing and a lateral locking plate with the RIA bone grafting technique enhances biological properties, provides good structural support, and achieves good union and functional results in the management of resistant nonunion of the distal femur.
本研究旨在评估髓内钉联合外侧锁定钢板结合扩髓冲洗吸引（RIA）植骨技术治疗难治性股骨远端骨不连的疗效。
本回顾性观察研究于 2018 年 1 月至 2021 年 12 月进行，共纳入 5 例经多次手术治疗仍存在难治性股骨远端骨不连的患者。他们采用髓内钉联合外侧锁定钢板结合 RIA 植骨技术治疗。术后随访观察愈合时间，采用下肢功能量表（LEFS）评估功能结果。
患者平均随访 17.9 个月后，所有患者均观察到完全骨愈合（平均愈合时间为 4.8 个月）。一位老年患者术后伤口失败，通过重新缝合和营养支持成功治疗。末次随访时，LEFS 评分平均为 71.2/80，膝关节屈曲平均为 109 度。
我们的研究表明，髓内钉联合外侧锁定钢板结合 RIA 植骨技术增强了生物特性，提供了良好的结构支撑，在治疗难治性股骨远端骨不连方面取得了良好的愈合和功能结果。
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