Ring D, Jupiter J B, Sanders R A, Quintero J, Santoro V M, Ganz R, Marti R K
Department of Orthopaedics, Massachusetts General Hospital, Boston 02114, USA.
J Bone Joint Surg Br. 1997 Mar;79(2):289-94. doi: 10.1302/0301-620x.79b2.6886.
We have treated 42 consecutive complex ununited fractures of the femoral shaft by wave-plate osteosynthesis at five different medical centres. There were 13 with previous infection, 12 with segmental cortical defects, and 3 were pathological fractures. In 39 cases there had been previous internal fixation and 21 patients had had more than one earlier operation. Union was achieved in 41 patients at an average of six months, although three had required a second bone graft. Two patients had recurrence of infection and in one this resulted in the persistence of nonunion. There were no failures of the implant. All 41 patients with union are now fully weight-bearing, but four have a leg-length discrepancy, one has axial malalignment, and nine have residual stiffness of the knee. These results are surprisingly good, despite the complexity of the initial problem, and appear to confirm the biological and mechanical advantages of the wave plate over the conventional plate for such cases.
我们在五个不同的医疗中心对42例连续性股骨干复杂骨不连患者采用波形钢板接骨术进行了治疗。其中13例曾有感染史，12例有节段性皮质缺损，3例为病理性骨折。39例曾接受过内固定治疗，21例患者曾接受过不止一次早期手术。41例患者平均在六个月时实现了骨愈合，尽管有3例需要进行二次植骨。2例患者感染复发，其中1例导致骨不连持续存在。植入物无失败病例。所有41例骨愈合患者目前均已完全负重，但4例存在腿长差异，1例有轴向畸形，9例有膝关节残余僵硬。尽管初始问题复杂，但这些结果出奇地好，似乎证实了波形钢板在此类病例中相对于传统钢板在生物学和力学方面的优势。
