长骨医源性骨不连的临床流行病学调查  

Clinical epidemiology and analysis of iatrogenic long bone nonunion

作　　者：李冀[1] 赵伟超[2] 关鹏飞[1] 王舒新[1] 葛欣昌[1] 焦翔[1] 陈长河[1] 

机构地区：[1]河北省唐山市第二医院创伤科,063000 [2]解放军第252医院手足外科

出　　处：《中国骨与关节损伤杂志》2012年第1期34-36,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨长骨骨干医源性骨不连的流行病学特征及原因。方法对自2005年1月～2009年2月期间收治的185例肱骨、股骨、胫骨无菌性骨不连,进行了流行病学调查,其中134例与医源性有关。回顾调查此类骨不连的流行病学特征及分析引起医源性骨不连的各种相关因素。结果骨不连的发生部位:肱骨、股骨、胫骨分别占24%、31%、45%;骨不连的患者以青壮年为主;其中骨不连肥大型62例,萎缩型72例;原复位方式切开复位占72%,闭合复位的占15%,有限切开复位占13%;内固定术不能为骨折愈合提供充分的力学稳定51例,手术操作问题11例,内固定技术理念的偏差84例,不恰当的康复指导24例。结论熟悉骨不连的流行病学特点,对于治疗和预防骨不连发生具有重要的意义。Objective To investigate epidemiology and causes of the iatrogenic nonunion in shaft of long bone.Methods From Jan.2005 to Feb.2009,134 cases of iatrogenic nonunion of long bones,which were selected from 185 long bones nonunion,were investigated and the epidemiological characteristics and various iatrogenic factors were analyzed.Results Iatrogenic nonunion of long bones occured in humerus,femur and tibia were 24%,31% and 45% respectively.Cases of nonunion were mainly young ages.Hypertrophic nonunion occured in 62 cases and atrophic nonunion in 72 cases.Original reset open reduction in 72%,closed reduction in 15%,limited open reduction in 13%.Internal fixation for the fracture healing could not provide sufficient mechanical stability of 51 patients,the operation was the problem in 11 cases,fixation of the wrong conception in 84 cases,inappropriate rehabilitation guidance in 24 patients.Conclusion It is important to be familiar with the epidemiological characteristics of nonunion for treating and preventing iatrogenic nonunion occurred.

关 键 词：长骨 骨不连 医源性 内固定 临床流行病学 

分 类 号：R581.3[医药卫生—内分泌]