| 股骨干骨折骨不连的治疗 |
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Received:November 27, 1998 Revised:March 10, 1999
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| 期刊信息：《中国骨伤》2000年13卷，第8期，第465-467页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:对近5年收治的51例股骨干骨折骨不连进行总结,探讨股骨干骨折骨不连的治疗方法。
方法:分别采用调整内固定物加植骨治疗8例,更换不同钢板加植骨治疗14例,外固定架加植骨治疗29例。
结果:51例中48例在平均6.3个月达到临床愈合,13人出现膝关节活动障碍。其中9例再次行膝关节松解术。
结论:预防骨不连的关键在于术中无创操作,尽量少剥离骨膜并在术后尽可能将其复位。骨折尽可能解剖复位。骨缺损尤其是压力侧骨缺损是产生骨不连的重要原因,应予以修复。选择合适的内固定物,而且只有在X线上出现连续骨痂时方可部分持重行走。带有皮质的髂骨作为植入骨效果较好,既有一定强度,又能尽快恢复血运。采用合理的内固定物并注意膝关节功能练习。 |
| [关键词]:骨折 股骨干 骨折固定术 内 不连接性 |
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| Surgical treatment of nonunion of femoral shaft fracture |
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Abstract:
Objective:To review 51 patients with nonunion of femoral shaft fracture encountered in the last 5 years,and to explore the methods of its treatment.
Methods:All the cases had nonunion after operation in an average duration of 10.5 months;35 cases had bone defects on the concave side.Of the 51 cases,8 were treated with adjustment of the internal fixation device and bone graft;14 with different types of compression plates and bone grafts,29 with application of the multifunctional external fixation apparaturs and bone grafts.
Results:48 cases obtained clinical healing in 6.3 months.Function of the knee was limited in the other 13 cases,while 9 cases had secondary relaxation procedure of the knee joint.
Conclusion:The key steps to prevent femoral shaft nonunion are as follows:protection of the intact tissue during the operation,stripping of the periosteum as little as possible,repair of any bone defect at the fracture site especially on the concave side,selection of suitable internal fixation device.Partial weight-dearing could be instituted after continuous callus appeared around the fracture site.Iliac crest cortico-cancellous as onlay or inlay bone grafts are excellent,because of their intensity and instant recovery of the blood supply.Exercises of knee should be timely instituted. |
| KEYWORDS:Fracture femoral shaft Fracture fixation internal Fracture nonunion |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 谷长跃,武汉,徐国会,崔建国.股骨干骨折骨不连的治疗[J].中国骨伤,2000,13(8):465~467 |
| 英文格式: | GU Chang-yue,WU Han,XU Guo-hui.Surgical treatment of nonunion of femoral shaft fracture[J].zhongguo gu shang / China J Orthop Trauma ,2000,13(8):465~467 |
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