股骨骨不连二次手术原方案固定的合理性分析  

Rationality analysis of the second operation for femoral nonunion with internal fixation

作　　者：金军伟 赵刚 

机构地区：[1]解放军152中心医院骨二科,河南平顶山46700

出　　处：《中国骨伤》2016年第1期48-51,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的 ：分析二次手术采用原方案固定治疗股骨骨不连的合理性。方法 ：回顾性分析自2009年1月至2014年7月收治的股骨骨折术后骨不连并行原方案固定患者19例,男14例,女5例;年龄18-75岁,平均（43.63±3.95）岁;首次内固定：钢板11例,交锁髓内钉8例,其中3例股骨远端逆行髓内钉。萎缩性骨不连13例,肥大性骨不连6例。观察二次手术后骨折愈合时间和骨折愈合后髋关节Harris评分和膝关节活动度。结果：所有患者二次术后均得到随访,时间6-30个月,平均（18.67±7.59）个月。患者二次术后均获得骨性愈合,影像学愈合时间7-29个月,平均（15.78±4.97）个月。髋关节Harris评分由术前（62.37±19.48）分提高到骨折愈合后（87.42±8.86）分;膝关节活动度由术前（52.16±20.10）°提高到骨折愈合后（96.32±22.10）°。结论：使用原固定方案治疗股骨骨折术后骨不连可获得较好的临床愈合率,其理论上具有合理性。Objective：To analyze rationality of internal fixation with original fixation in the second operation for femoral nonunion. Methods：A retrospective study was conducted to analyze the clinical data of 19 femoral nonunion patients treated by internal fixation with original fixation in the second operation since January 2009 to July 2014,including 14 males and 5 females with an average age of（43.63±3.95） years old ranging from 18 and 75 years old. The original fixations involved plate fixation in11 cases and interlocking intramedullary nail in 8 cases（including 3 cases of retrograde interlocking intramedullary nails）. There were 13 cases of atrophic nonunion and 6 cases of hypertrophic nonunion in pathological classification. After second operation,the fracture healing time,Harris hip score and range of motion of the knee joint was recorded and compared with preoperative.Results：After the second operatioin,all patients were followed up for 6 to 30 months with an average of（18.67±7.59） months. All patients got fracture healing,and the fracture radiological healing time was from 7 to 29 months with an average of（15.78±4.97）months. Harris hip scores were improved from preoperative 62.37±19.48 to postoperative 87.42±8.86. The range of motion of the knee joint was improved from preoperative（52.16±20.10）° to postoperative（96.32±22.10）°. Conclusion：It has a better clinical healing rate for using original fixation to treat femoral nonunions,and theoretically speaking it was rationality.

关 键 词：股骨骨折 骨折 不愈合 骨折固定术 内 外科手术 

分 类 号：R684.7[医药卫生—骨科学]