Department of Orthopaedics and Trauma, Ganga Medical Centre & Hospitals Pvt Ltd, Tamil Nadu, India.
Department of Orthopaedics and Trauma, Ganga Medical Centre & Hospitals Pvt Ltd, Tamil Nadu, India.
Injury. 2024 Mar;55(3):111412. doi: 10.1016/j.injury.2024.111412. Epub 2024 Feb 1.
Our primary aim of the study was to assess the results of a treatment protocol for aseptic femoral shaft nonunion treated by three techniques - Exchange Nailing (EN), Plate Augmentation (PA), and Exchange Nailing combined with Plate augmentation (NP). The secondary objective was to assess the radiological outcome, duration of surgery (DOS) and need for blood transfusion (BT) in all the three groups.
We analyzed 330 patients treated for AFNU between Jan 2007 and Dec 2019. Using a simple treatment algorithm, EN, PA and NP were performed in 24,183 and 123 patients respectively. Patients in all the three groups were assessed for radiological-union (union rate and time to union), DOS and BT.
Of these 330 patients, 327 (99 %) patients achieved radiological union at a mean duration of 6.07 months. Union rate is highest with NP followed by PA and EN. The union rate in patients with NP, PA and EN were 100 %, 99.5 % and 91.7 % respectively (p < 0.01). Time to union was lowest for NP followed by PA and EN (p < 0.001).The mean time to union for NP, PA and EN were 3.76, 7.2and 9.21 months respectively (p < 0.001). The mean DOS in minutes for NP, EN and PA was 107, 94 and 82 respectively (p < 0.01). The mean need for BT in the form of packed red blood cells for NP, PA and EN were 1.95, 1.87 and 1.38 units respectively (p < 0.01).
Following a simple algorithm to decide treatment protocol on a case-to case basis helps to achieve good results in an optimal time period. When compared with EN and PA, NP is associated with 100 % union rate with least time to union making NP a reasonably effective procedure with a very high success rate.
IV.
本研究的主要目的是评估三种技术治疗无菌股骨干骨不连的治疗方案的结果-交锁髓内钉（EN）、钢板增强（PA）和交锁髓内钉联合钢板增强（NP）。次要目标是评估所有三组的影像学结果、手术持续时间（DOS）和输血（BT）需求。
我们分析了 2007 年 1 月至 2019 年 12 月期间治疗的 330 例 AFNU 患者。使用简单的治疗算法，分别对 24 例、183 例和 123 例患者进行了 EN、PA 和 NP。所有三组患者均评估了影像学愈合（愈合率和愈合时间）、DOS 和 BT。
330 例患者中，327 例（99%）患者在平均 6.07 个月时达到影像学愈合。NP 组的愈合率最高，其次是 PA 和 EN。NP、PA 和 EN 患者的愈合率分别为 100%、99.5%和 91.7%（p<0.01）。NP 组的愈合时间最短，其次是 PA 和 EN（p<0.001）。NP、PA 和 EN 的平均愈合时间分别为 3.76、7.2 和 9.21 个月（p<0.001）。NP、EN 和 PA 的平均 DOS 分别为 107、94 和 82 分钟（p<0.01）。NP、PA 和 EN 的平均输血（以单位浓缩红细胞形式）需求分别为 1.95、1.87 和 1.38 单位（p<0.01）。
根据具体病例决定治疗方案的简单算法有助于在最佳时间段内取得良好的效果。与 EN 和 PA 相比，NP 具有 100%的愈合率和最短的愈合时间，因此 NP 是一种合理有效的治疗方法，成功率非常高。
IV。
