经皮微创定点取骨、植骨治疗股骨、胫骨内固定术后骨不连、骨延迟愈合的疗效观察  

Curative Effect Observation of Percutaneous Minimally Invasive Fixed-point Bone extraction and Grafting after the Treatment of Femoral or Tibial Internal Fixation in Nonunion or Delayed Union

作　　者：马邦兴 任绍东 陈泽群 屠永刚 张史飞 MA Bang-xing REN Shao-dong CHEN Ze-qun et al

机构地区：[1]广东省东莞市常平医院,广东东莞523573

出　　处：《中国医学创新》2017年第16期46-50,共5页Medical Innovation of China

摘　　要：目的:探讨使用经皮微创定点取骨器微创取骨、经皮微创植骨的方法治疗16例内固定术后股骨、胫骨骨不连或骨延迟愈合患者的临床疗效。方法:选取2010年1月-2016年7月采用自制经皮微创定点取骨器微创取骨、经皮微创植骨方法治疗的股骨、胫骨内固定术后骨不连或骨延迟愈合患者16例。对患者术中及术后情况进行统计,观察患者取骨量、取骨及植骨手术时间、出血量、术后并发症、住院天数、骨的愈合情况。结果:本组16例患者均获随访,随访时间6~35个月,平均(14.8±1.7)个月。16例病例中单处单向取骨8例,单处双向取骨7例,多点取骨1例,平均取骨量(3.9±1.6)cm^3,平均取骨时间(6.8±1.3)min,植骨时间平均(13.5±1.2)min,平均取骨出血量约(5.9±1.1)mL,植骨平均出血量约(10.9±1.4)mL,平均住院天数为5 d。15例骨折延迟愈合或骨不连患者在术后5~11个月达到骨性愈合,平均(7.3±1.1)个月。1例植骨部位出现浅表皮肤感染,1例出现取骨部位伤口血肿,1例胫骨中下1/3骨不连患者植骨后12个月X线片中骨折线仍然明显,无骨痂连接。所有病例均未出现骨髓炎、骨化性肌炎,内固定松动、钉板断裂等并发症。结论:经皮微创定点取骨器微创取骨、微创植骨具有操作简便、创伤小、出血少、手术及住院时间短、并发症少、愈合快等优点,对治疗股骨、胫骨术后骨不连、骨延迟愈有良好的疗效。Objective To iny, estigate tlge curative effect of minimally in,vasive fixed-point percutaneous iliac bone graft in the treatment of 16 patients with femoral or tibial of nonunion or delayed union of bone after internal fixation.Method： From Jcmuary 2010 to July 2016, 16 patients of femoral or tibial in nonunion or delayed union of bone were selected with our self-made percutaneous minimally invasive instrument fixed-point internal fixation graft the bone.The the volume of Bone graft, operation time, bleeding volume, postoperative complications, hospital stays, bone healing condition of all the patients were observed.Result： All the 16 patients were followed up 6 to 35 months, averase of（ 14.8 ±1.7 ） months.Among 16 cases, 8 cases were one point one direction, 7 cases were one point two directions, 1 case of multiple point bone graft, the average bone volume was （ 3.9 ± 1.6 ） cm3, the average time of Iliac bone graf was （ 6.8 ± 1.3 ） min, the average time of bone grafting was （ 13.5 ± 1.2 ） min, the average bleeding volume of bone taking was （ 5.9 ± 1.1 ） mL, the average bleeding volume of bone grafting was about （ 10.9 ± 1.4 ） mL, the average hospital stays were 5 days. 15 cases＇ bone healing within 5-11 months, the operation average were （7.3 ± 1.1 ） months. 1 case＇s bone graft site appeared superficial skin infection, 1 case＇s donor site appeared wound hematoma, 1 case＇s 1/3 lower tibial nonunion X-ray after bone grafting 12 months showed the fracture line still evident, no bone callus connection.Osteomyelitis, ossificans myositis internal fixation loosening, plate fracture and other complications were not found in all cases.Conclusion： Minimally invasive fixed-point and percutaneous bone graft is a simple and easy way for operation, can reduce trauma and bleeding, shorten 0pration time and hospital stays, decreace the complications and accelerate healing, which has a good effect for femoral or tibial nonunion or delayed union of bone after internal fixation.

关 键 词：微创取骨术 微创植骨术 骨移植 骨不连 骨延迟愈合 

分 类 号：R687.3[医药卫生—骨科学]