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280例骨不连病例原因分析
Hits: 2155   Download times: 1404   Received:February 25, 2013    
作者Author单位UnitE-Mail
潘治军 PAN Zhi-jun 榆林市第四医院, 陕西 榆林 719000  
杨涛 YANG Tao 榆林市第四医院, 陕西 榆林 719000  
思玉楼 SI Yu-lou 榆林市第四医院, 陕西 榆林 719000  
李丽萍 LI Li-ping 榆林市第四医院, 陕西 榆林 719000  
王汉利 WANG Han-li 榆林市第四医院, 陕西 榆林 719000  
李艳华 LI Yan-hua 榆林市第四医院, 陕西 榆林 719000  
罗卓荆 LUO Zhuo-jin 第四军医大学第一附属医院, 陕西 西安 710000 The First Affiliated Hospital of the Fourth Military Medical University, Xi'an 710000, Shaanxi, China CKX0912@tom.com 
期刊信息:《中国骨伤》2013年26卷,第4期,第284-286页
DOI:10.3969/j.issn.1003-0034.2013.04.006
基金项目:国家自然科学基金项目资助(编号:30973052);榆林市科技计划项目(编号:SF11-20)


目的: 通过对大宗骨不连病例的临床资料回顾性研究, 以求发现骨生长能力低下的原因。

方法: 1999年10月至2009年4月, 对280例骨不连病例进行回顾性研究, 男230例, 女50例;年龄19~62岁, 平均39.4岁。股骨129例, 胫骨83例, 肱骨47例, 尺桡骨21例。调查内容包括原发损伤经过及损伤程度, 首次治疗情况包括首诊医院级别、首次手术时机、早期骨痂生长状况、是否有明显的技术错误。

结果: 股骨骨不连资料完整者129例, 源于闭合骨折121例, 开放骨折8例。无菌性骨不连111例。 90%早期无明显骨痂生长, 首次治疗80%为伤后当天手术内固定, 10%为伤后3 d以内手术, 总计90%为早期手术。

结论: 骨痂生长能力低下是当前骨不连的重要原因, 早期手术与骨痂生长能力低下有很大的相关性。在内固定如此发达的时代仍然存在较多不明原因的骨不连, 这一现象似乎与内固定手段无关, 而与骨生长能力低下有关。
[关键词]:骨折  不愈合  骨不连  骨缺损  治疗
 
Cause analysis of 280 case of fractures nonunion
Abstract:

Objective: To research many clinical data of nonunion cases and discover the reasons for low capacity of bone growth.

Methods: From October 1999 to April 2009,the source material of 280 nonunion cases were conducted and followed up. The data of the study included 230 males and 50 females,with an average age of 39.4 years old ranging from 19 to 62 years. The fracture position was femur in 129 cases,tibia in 83 cases,humerus in 47 cases,feet radius bone in 21 cases,the ratio was 46∶29.6∶16.8∶7.5. The survey included primary injury process,damage degree and the effect of first treatment,hospital level of first treatment,timing of surgery for the first time,the early callus growth conditions and whether there were obvious technical errors.

Results: There were 129 femoral nonunion cases with complete data,121 cases derived from closed fractures,8 cases from open fractures;111 cases was aseptic nonunion. 90% of femoral aseptic nonunion had no obvious callus growth,80% of first treatment performed intraday surgical internal fixation,10% were undergone operation within three days and 90% was early surgery totally.

Conclusion: Low quality of bone callus growth is the main reason for current nonunion and the early surgical fixation has much to do with low quality of bone callus growth.
KEYWORDS:Fractures,ununited  Nonunion  Bone defect  Therapy
 
引用本文,请按以下格式著录参考文献:
中文格式:潘治军,杨涛,思玉楼,李丽萍,王汉利,李艳华,罗卓荆.280例骨不连病例原因分析[J].中国骨伤,2013,26(4):284~286
英文格式:PAN Zhi-jun,YANG Tao,SI Yu-lou,LI Li-ping,WANG Han-li,LI Yan-hua,LUO Zhuo-jin.Cause analysis of 280 case of fractures nonunion[J].zhongguo gu shang / China J Orthop Trauma ,2013,26(4):284~286
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