股骨干骨折带锁髓内钉固定术后骨折不愈合临床原因分析  

The analysis of femoral shaft fractures nonunion after intramedullary nail fixation

作　　者：贾金生[1] 范步新[1] 刘书茂[1] 刘长松[1] 

机构地区：[1]首都医科大学大兴医院骨科,北京102600

出　　处：《生物骨科材料与临床研究》2012年第5期42-45,共4页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨股骨干骨折带锁髓内钉内固定术后出现骨折不愈合的原因。方法对2005年1月~2011年6月期间收治的15例股骨干骨折带锁髓内钉内固定术后骨折不愈合病例进行回顾性分析。结果 15例患者骨折分型C型7例,B型5例,A型3例;采用切开复位11例,应用钢丝环扎固定2例;骨折复位不良6例,髓内钉过细2例,深部感染1例;伴随糖尿病等慢性消耗性疾病4例;再次术中发现软组织嵌入3例。15例患者均再次手术治疗,手术包括骨折端清理、自体髂骨松质骨植骨、附加或更换内固定物稳定骨折端等,术后获得随访6~24个月,平均12.2个月,骨折均获愈合,平均愈合时间4.3个月。结论股骨干骨折带锁髓内钉固定术后骨折愈合受多重因素影响,其中手术治疗技术的缺陷是最常见的原因。Objective To investigate the causes of bone nonunion of femoral shaft fracture treated with inter-locking intramedullary nail fixation Methods 15 cases of bone nonunion of femoral shaft fracture treated by inter-locking intramedullary nail fixation from January 2005 to June 2011 were analyzed.Results All of the 15 cases,7 cases were C type,5 case were B type,3 cases were A type.There were 11 cases managed by open reduction.2 cases fixed with Steel wire.Relatively wide gap was found in 6 cases after operation.1 case got infecton.4 cases accompanied with chronic disease.3 cases had soft tissue insertion.All cases were obtained ideal union with an average healing time of 4.3 months after treated by operation again.Conclusion Among various factors which contributed to bone nonunion of femoral shaft fracture after inter-locking intramedullary nail fixation,operation techniques defects is the first factor.

关 键 词：股骨干骨折 骨折不愈合 髓内钉内固定 

分 类 号：R687.3[医药卫生—骨科学]