胫骨内固定术后非感染性骨不连的原因分析及治疗  

Analysis on the Cause and Treatment of Aseptic Tibial Shaft Nonunion After Internal Fixation

作　　者：彭国常[1] 汪玉辉[1] 李跃[1] 丁浩[2] 

机构地区：[1]安徽省天长市人民医院骨科,安徽天长239300 [2]南京军区南京总医院骨科,江苏南京210002

出　　处：《临床医学工程》2014年第1期52-53,共2页Clinical Medicine & Engineering

摘　　要：目的观察胫骨内固定术后非感染性骨不连手术与非手术治疗的效果。方法自2006年5月至2012年12月．对29例胫骨内固定术后非感染性骨不连患者采用骨端清理＋髓内钉、钢板、外固定支架固定联合自体植骨手术治疗或金葡液骨折断端注射方法的非手术治疗。结果29例均获随访，随访时间10～24个月，X线片均见骨折愈合。依据采用Johner—Wmh评定标准：优15例，良12例，一般2例。半年内愈合者8例，1年内愈合者18例，大于1年愈合者3例；所有患者均于骨折愈合后取除固定物，恢复正常工作。结论胫骨内固定术后非感染性骨不连可根据其类型选择非手术或手术治疗方式达到满意的治疗效果。Objective To observe the effect of operative treatment and non-operative treatment for aseptic tibial shaft nonunion after internal fixation. Methods 29 patients with aseptic tibial shaft nonunion after internal fixation from May 2006 to December 2012 were treated with operation （bone-side cleanup ＋ intramedullary nail, plate and external fixation combined with autologous bone graft） or staphylococcus aureus injection on fracture site. Results All 29 patients were followed-up for l0 - 24 months, and all cases had fracture healing under X-rays. According Johner-Wruh evaluation standards, there were 15 cases of excellent, 12 cases of good and 2 cases of common. 8 cases were healed within 6 months, 18 cases were healed within 1 year, and 3 cases were healed more than 1 year. All patients removed fixation materials after fracture healing, and resumed normal work. Conclusions Non-operative treatment or operative treatment reasonably according to fracture types and formation factors can achieve satisfying treatment effect for patients with aseptic tibial shaft nonunion after internal fixation.

关 键 词：胫骨骨不连 锁定加压钢板 外固定支架 髓内钉 金葡液 

分 类 号：R619[医药卫生—外科学]