单臂外固定架治疗胫骨骨不连临床疗效分析  

Clinical analysis on the outcome of single brachial external fixation in treating tibial nonunion

作　　者：陈振强[1] 孙占胜[1] 许世宏[1] 

机构地区：[1]山东大学山东省立医院创伤骨科中心,山东济南250021

出　　处：《中国骨伤》2006年第5期281-283,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨单臂外固定架治疗带锁髓内钉术后胫骨骨不连的临床疗效。方法:带锁髓内钉术后胫骨骨不连患者47例,男40例,女7例;年龄22～61岁,平均37.5岁;带锁髓内钉固定时间11～26个月;胫骨中上段骨折11例,中下段36例。先按原切口取出带锁髓内钉,选择合适的切口修整骨折端硬化骨,行腓骨斜行截骨植骨,全部采用单臂外固定支架固定并髂骨植骨治疗。结果:47例均获随访,时间12～36个月。44例骨折愈合;2例再次出现骨不连,经单纯植骨加压外固定治疗愈合;1例感染并骨不连,控制感染后采用管形石膏加植骨治疗后愈合。术后并发骨筋膜室综合征3例,踝关节僵直11例,患肢不等长6例。结论:单臂外固定架治疗胫骨骨不连,方法简单,固定可靠,减少患者痛苦。Objective ： To explore the outcome of single brachial external fixation in treating tibial nonunion after interlocking intramedullary nail fixation. Methods ： Forty-seven patients with tibial nonunion after interlocking intramedullary nail fixation included 40 male and 7 female with the average age of 37.5 years ranging from 22 to 61 years. The time of the internal fixation was from 11 to 26 months. Eleven patients of bone ununion were in middle and superior segment tibia, and 36 were in middle and inferior segment. The interlocking intramedullary nail were taken out through the old incision. The harden bone of fracture end were repaired and planted the fibula bone flap. Then all patients were treated by single brachial external fixation and planted the iliac bone flap. Results：All patients were followed up for from 12 to 36 months. Fort-four patients were fracture union. Two patients of still bone nonunion were treated by bone graft and pressurized external fixation to obtain bone union. One patient of infection were treated by plaster cast fixation and bone graft after control infection. Postoperative complication were including osteofascial compartment syndrome in 3 cases, ankle joint stiffness in 11 cases, injuried extremity inequi long in 6 cases. Conclusion ： The single brachial external fixation is an effective method to treat tibial nonunion. It is characterized by simple, fixation firmly and decreaseing pains of patiens.

关 键 词：胫骨骨折 骨折 不愈合 外固定器 

分 类 号：R682.6[医药卫生—骨科学] R683.420.5[医药卫生—外科学]