陈旧性骨折骨不连的临床治疗研究  

Clinical research of chronic fracture nonunion management

作　　者：贾世孔[1] 

机构地区：[1]天津市人民医院骨科,天津市红桥区芥园道130号300121

出　　处：《中国矫形外科杂志》2008年第20期1541-1543,1556,共4页Orthopedic Journal of China

摘　　要：[目的]总结锁定加压钢板内固定加自体骨移植以及Illizarov技术治疗陈旧性骨折骨不连的经验,探讨骨不连的病因,评价手术的安全性和有效性。[方法]回顾性分析了本院从2002年1月-2007年7月手术治疗的骨不连患者共87例,所有患者均为骨折切开复位内固定术后骨不连,手术取出内固定物后,改用锁定加压钢板加自体骨移植治疗80例,Illizarov技术治疗7例。对其骨折愈合率、手术并发症、临床结果进行评价。[结果]本组共87例患者,得到随访82例,随访时间6~24个月,平均14.7个月。随访患者均获得骨性愈合,骨折愈合时间为4~10个月,平均6.8个月。得到随访的82例患者中,70例患者临近关节功能较术前改善,肢体功能优良。12例遗留有临近关节的功能障碍,均与患者术前肢体长期固定或失用有关。无内固定失败等并发症。[结论]医源性因素是骨折切开复位内固定术后骨不连的主要原因,骨折部位的解剖特点、骨折类型以及术后感染也是骨折后骨不连的重要原因。锁定加压钢板内固定加自体骨移植以及Illizarov技术是治疗陈旧性骨折骨不连的安全、有效的方法。[ Objective] To discuss the experience with locking compression plates fixation combining with autoallergic cancellous bone and Illizarov technique in the management of chronic fracture nonunion, and to further investigate the reason of fracture nonunion and assess the safety and the efficacy of this procedure. [ Method ] A retrospective analysis was made including 87 consecutive patients with fracture nonunion treated at our hospital with locking compression plates fixation combining with autoallergic cancellous bone（ 80 cases） and Illizarov technique （7 cases） from January 2002 to July 2007. Patients were evaluated for radiographic bony fusion, complications and clinical outcome. [ Result] Mean follow -up period was 14.7 months. Bony union was achieved in all cases after a mean time of 6.8 months after operation. Joint function was improved after operation in 70 patients. No major complications related to the procedure or hardware failure occurred. [ Conclusion] Medical factors are main etiopathogenisis of chronic fracture nonunion after operation. Locking compression plates combining with autoallergic cancellous bone and Illizarov technique are safe and effective procedure for the treatment of fracture nonunion.

关 键 词：骨不连 锁定加压钢板 植骨 Illizarov技术 

分 类 号：R687.3[医药卫生—骨科学]