辅助锁定钢板植骨治疗髓内钉术后股骨骨不连  

Augmentative locking plate for treatment of non-union of femoral shaft fracture after intramedullary nailing interfixation

作　　者：吴作培[1] 陈春华[1] 龚冲丞[1] 姚中凯[1] 孙贵新[1] 

机构地区：[1]同济大学附属东方医院急诊创伤外科,上海200120

出　　处：《同济大学学报（医学版）》2016年第2期92-95,共4页Journal of Tongji University(Medical Science)

基　　金：上海市科委面上项目(13ZR1434100)

摘　　要：目的 探讨辅助锁定钢板治疗髓内钉固定术后股骨骨不连疗效。方法 2008年1月至2013年9月,6例股骨干骨折髓内钉固定术后骨不连患者,男4例,女2例,年龄25～55岁,平均（35.2±7.8）岁,骨折至髓内钉手术时间为1～5 d,平均2.5±1.3 d,髓内钉术后出现骨折不愈合时间8～18个月,平均时间为（11.3±5.6）个月,所有患者在动力化治疗之后保留原有髓内钉的基础上,采取有限切开辅助锁定钢板加自体髂骨移植治疗。结果 术后随访10～22个月（平均15.8±7.3个月）,6例患者术后4～10个月均出现骨性愈合,X线示骨痂连续性生长过骨折线或骨折线消失。伤口均I期愈合,未出现感染等异常,末次随访,髋膝关节活动良好,优良率达100%。结论在动力化治疗之后保留原有髓内钉的基础上,采用辅助锁定钢板联合自体髂骨移植治疗股骨干骨折髓内钉固定术后骨不连,手术创伤小,疗效确定,稳定可靠,是治疗髓内钉固定后股骨骨不连的有效方法。Objective To evaluate the efficacy of augmentative locking plate for treatment of nonunion of femoral shaft fracture after intramedullary nailing interfixation. Methods Six patients with non-union of femoral shaft fracture after intrarnedullary nailing interfixation were treated by augmentative locking plate and autogenous iliac grafting from January 2008 to September 2013. There were 4 males and 2 females with an average age of （35.2 ±7.8 ） years and with an average non-union time of （ 11.3 ± 5.6） months. Results All the 6 cases were followed up for 15.8 ±7.3 months （ 10 - 22 months） and X-ray imaging proved bone callus at the broken ends of the fracture at 4 - 10 months after surgery. No one case suffered from infection in the incision. For the function of joints, 6 patients （ 100% ） were excellent or good during the last time of the follow-up with. Conclusion Augmentative locking plate and autogenous iliac grafting for treatment of non-union of femoral shaft fracture after intramedullary nailing interfixation has advantages of less invasiveness, definite efficacyand stable fixation.

关 键 词：辅助锁定钢板 髓内钉 股骨骨折 骨不连 自体髂骨移植 

分 类 号：R683.42[医药卫生—骨科学]