| 微创内固定系统联合腓骨移植治疗股骨远端骨不连伴骨缺损 |
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Received:March 20, 2016
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| 期刊信息：《中国骨伤》2016年29卷，第8期，第723-728页 |
| DOI：10.3969/j.issn.1003-0034.2016.08.010 |
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| 目的：探讨股骨远端微创内固定系统LISS-DF（less invasive stabilization system-distal femur，LISS-DF）联合腓骨移植治疗股骨远端骨不连伴骨缺损的临床疗效。方法：2007年6月至2014年9月，采用微创锁定内固定系统联合腓骨移植技术治疗12例股骨远端骨不连伴骨缺损患者，男10例，女2例；年龄30～77岁，平均（56.2±14.1）岁。受伤至骨不连翻修时间9～26个月，平均（16.4±5.5）个月。根据Weber-Cech分型：12例均为萎缩性骨不连；Paley分型属于骨缺失型（B1）.术后进行临床和影像学随访评估，对比术前术后美国膝关节协会评分（American Knee Society Score，KSS）情况，包含膝关节临床评分和功能评分。结果：所有患者获得随访，时间12～17个月，平均（13.7±1.9）个月。所有骨不连获得骨性愈合，骨不连愈合时间4～8个月，平均（6.2±1.3）个月。患膝关节平均屈伸运动范围（range of movement，ROM）从术前（67.1±29.6）°提高至术后末次随访时的（102.5±13.6）°，差异有统计学意义。术后患者KSS疼痛、膝关节活动度评分和KSS临床总分以及功能评分与术前相比，差异有统计学意义。术后无感染，内固定松动、断裂等并发症发生。结论：LISS-DF内固定结合腓骨移植能有效治疗股骨远端骨不连伴骨缺损。 |
| [关键词]:股骨骨折 骨折,不愈合 骨折固定术,内 骨移植 腓骨 |
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| Treatment of distal femur nonunion with bone defect by less invasive stabilization system and fibular strut graft |
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| Abstract:Objective: To evaluate the therapeutic effects of less invasive stabilization system-distal femur(LISS-DF) combined with fibular struts graft for distal femur nonunions and bone defects. Methods: A total of 12 patients with distal femur nonunion and bone defect were underwent revision operation with locked plating,plus a nonvascularized autologous fibular strut bone graft from June 2007 to September 2014,including 10 males and 2 females with an average age of(56.2±14.1) years old ranging from 30 to 77 years old. The mean time from the initial trauma to the last revision operation was(16.4±5.5) months (ranged from 9 to 26 months). All cases were atrophic nonunions according to Weber-Cech classification and type B1 (bone loss) according to Paley classification. All patients were followed up and evaluated with clinical and imaging results. The KSS (American Knee Society Score) scores including knee clinical score and knee functional score were compared before and after the treatment. Results: All patients were followed up from 12 to 17 months with an average of(13.7±1.9) months. All nonunions healed with an average time of(6.2±1.3) months(ranged from 4 to 8 months). The average range of movement (ROM) of the knee was improved from(67.1±29.6)° preoperatively to (102.5±13.6)° at the last follow-up. KSS scores including knee pain,range of motion,clinical and functional score were significantly different before and after operation. No such complications as infection,hardware loosening or breakage occurred postoperatively. Conclusion: LIFF-DF fixation and autologous fibular strut bone graft facilitated the successful treatment of distal femur nonunions with bone defects. |
| KEYWORDS:Femoral fractures Fractures,ununited Fracture fixation,internal Bone transplantation Fibula |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 高堪达,王秋根.微创内固定系统联合腓骨移植治疗股骨远端骨不连伴骨缺损[J].中国骨伤,2016,29(8):723~728 |
| 英文格式: | GAO Kan-da,WANG Qiu-gen.Treatment of distal femur nonunion with bone defect by less invasive stabilization system and fibular strut graft[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(8):723~728 |
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