应用外固定架治疗骨折不愈合  

Treatment of nonunion of fractures with external fixator

作　　者：林欣[1] 潘海涛[1] 麻松[1] 胡宝岩[1] 宋磊[1] 邢汝鹏[1] 

机构地区：[1]首都医科大学北京天坛医院骨科,北京100050

出　　处：《临床骨科杂志》2005年第1期26-28,共3页Journal of Clinical Orthopaedics

摘　　要：目的　探讨外固定架治疗骨折不愈合的有效方法和疗效。方法　自行研制可调式单臂或半环型外固定架,根据骨折部位、稳定程度和皮肤软组织情况决定针数、针距及外固定架类型。临床应用 43例,其中合并骨髓炎 13例。单纯骨折不愈合病例均予髓内、外植骨;合并骨髓炎则予以冲洗及皮瓣移植控制感染,二期行植骨手术。结果　1次手术治愈 32例, 2次手术治愈 10例,截肢 1例。移植皮瓣 13例,皮瓣全部成活 12例,部分坏死 1例。结论　早期稳定的外固定架配合髓内外植骨是治疗骨折不愈合的有效方法,部分合并感染者在治疗感染的同时,保持骨折端良好的对合和持久稳定,不植骨亦可达到愈合目的。Objective To develop an effective method for nonunion of fractures with external fixator. Methods Using self-made adjustable mono-arm or semicircle fixator, the number of the pins and the distance between them were all based on the position and the stability of the fractures and the condition of soft tissues. 43 cases were enrolled, of which 13 had osteomyelitis. If there was only nonunion of the fracture, intra-and extra-medullary bone graft was used. If associated with osteomyelitis,irrigating and flap grafting was used to control infections and bone grafting followed. Results 32 cases were cured after single operation, 10 of them were cured after two stage operations. 1 underwent amputation, 13 had skin flap grafting, 12 of which totally survived, and 1 had partial flap necrosis. Conclusions Early rigid external fixation with intra-and extra-medullary bone graft is effective to treat nonunion of fractures. With associated infections, provided good reduction and stable fixation, union could also be achieved without bone grafting.

关 键 词：骨折 不愈合 骨髓炎 外固定架 外科皮瓣 

分 类 号：R683[医药卫生—骨科学] R681.2[医药卫生—外科学]