| 股骨骨折钢板取出后再骨折的病理学观察 |
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投稿时间：2010-02-25
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| 作者 | Author | 单位 | Address | E-Mail |
| 涂泽松 |
TU Ze-song |
佛山市中医院骨科, 广东 佛山 528000 |
The Foshan Hospital of Traditional Chinese Medical,Foshan 528000,Guangdong,China |
tuzesong618@163.com |
| 李逸群 |
LI Yi-qun |
佛山市中医院骨科, 广东 佛山 528000 |
The Foshan Hospital of Traditional Chinese Medical,Foshan 528000,Guangdong,China |
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| 吴峰 |
WU Feng |
佛山市中医院骨科, 广东 佛山 528000 |
The Foshan Hospital of Traditional Chinese Medical,Foshan 528000,Guangdong,China |
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| 期刊信息：《中国骨伤》2010年，第23卷，第8期，第609-611页 |
| DOI：10.3969/j.issn.1003-0034.2010.08.016 |
| 基金项目: |
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中文摘要:
目的：探讨股骨骨折术后再骨折的原因及治疗方法。
方法：选取2004年至2008年股骨骨折钢板取出术后发生再骨折的病例10例，女4例，男6例；年龄19～48岁，平均33岁；原骨折根据Müller分型：A型4例，B型3例，C型3例。采用切开复位带锁髓内针进行固定治疗，并应用病理切片方法观察骨折端骨组织。
结果：所有患者均获得随访，时间10～18个月，平均14个月。10例伤口均Ⅰ期愈合，无并发症发生，均恢复下肢行走和负重功能。病理切片显示原骨折端部分骨质坏死，骨结构紊乱，毛细血管阻塞，可见新生血管和哈弗小管长入坏死骨质，并形成切割圆锥，证实原骨折端处于新生骨爬行替代坏死骨的过程。
结论：普通钢板内固定术后极大地破坏骨质血运，骨质坏死，影响骨质重建，造成骨力学性能下降，钢板取出后容易发生再骨折，应用切开复位带锁髓内针内固定的方法进行治疗，可达到较好的疗效。 |
| 【关键词】股骨骨折 骨折固定术,内 病理学,临床 |
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| Pathological observation of femoral refracture after removal of plates |
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ABSTRACT
Objective: To discuss the reasons and the treatments for the femoral refracture.
Methods: From 2004 to 2008,10 cases of femoral refracture after plate removal were selected and treated with open reduction and bone nail internal fixation,included 4 males and 6 females ranging from 19 to 48 years with an average age of 33 years old. According to Müller classification,there were 4 cases of type A,3 of B,3 of C. The skeletal tissues were taken for pathological analysis.
Results: Ten patients were followed-up for 10 to 18 months(averaged 14 months). All wound healed at one stage,there were no complications. The fuction of lower limbs walking and weight loading werer recovered. Pathological section showed that part of the lamellar bone tissues were necrotic. The bone architectures were chaotic,micrangium blocked,Haversian canals were atrophy,new vessels and Haversian canals growed in necrotic bone. The tunnel in rigid bone and new Haversian system were formed. The structure was cutting cone. It was the process of new bone substitutting necrotic bone in bony remodeling.
Conclusion: The internal fixation using ordinary plates overwhelmingly destroy blood circulation of bone and cause necrosis of bone. It can also effect bone remodeling and descent mechanical property. Refracture can readily happen after the plate removal. Treatment of open reduction and bone nail internal fixation can achieve excellent and good effect. |
| KEY WORDS Femoral fractures Fracture fixation,internal Pathology,clinical |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 涂泽松,李逸群,吴峰.股骨骨折钢板取出后再骨折的病理学观察[J].中国骨伤,2010,23(8):609~611 |
| 英文格式: | TU Ze-song,LI Yi-qun,WU Feng.Pathological observation of femoral refracture after removal of plates[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(8):609~611 |
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