桥接系统去皮质术治疗股骨干骨折不连接  

Bridging system fixation combined with decortication for femoral shaft nonunion

作　　者：张刚[1] 刘亚 冯源 李秉胜 ZHANG Gang;LIU Ya;FENG Yuan;LI Bingsheng(Department of Orthopedics,The 960^(th)Hospital,Joint Logistics Support Force of PLA,Jinan 250031,China)

机构地区：[1]中国人民解放军联勤保障部队第960医院骨科,山东济南250031

出　　处：《中国矫形外科杂志》2021年第16期1523-1526,共4页Orthopedic Journal of China

摘　　要：[目的]探讨桥接系统去皮质术治疗股骨干骨折钢板固定术后骨不连的临床疗效。[方法] 2017年1月—2018年12月收治29例股骨干骨折钢板固定术后骨不连患者。术中取出原内固定装置后采用桥接系统再次固定,同时结合去皮质术自体骨移植治疗。[结果]所有患者均顺利完成手术,术中无血管、神经损伤等严重并发症,手术时间(91.52±9.74) min,术中出血量(387.93±75.94) ml,住院时间(8.66±1.99) d。平均随访时间(17.24±3.79)个月。末次随访时Harris髋关节功能评分和HSS膝关节功能评分与术前相比较均显著增加(P<0.05)。末次随访时患者骨折均愈合,平均愈合时间(5.93±1.22)个月。[结论]桥接系统去皮质术治疗股骨干骨折不连接可以获得满意的临床疗效。[Objective] To explore the clinical outcomes of bridging system fixation combined with decortication for treatment of fracture nonunion of femoral shaft secondary to internal fixation with plate. [Methods] From January 2017 to December 2018, 29 patients underwent abovesaid surgical treatment for nonunion of femoral shaft fracture after plate fixation. After the original internal fixation device was removed, the bridging system was used to fix the femur again, and then the autologous bone grafting by decortication was conducted. [Results] All patients were operated on successfully without serious complications, such as vascular and nerve injuries, with operation time of(91.52±9.74) min, intraoperative blood loss of(387.93±75.94) ml, and hospital stay of(8.66±1.99) days. At the end of follow-up lasted for(17.24±3.79) months, the Harris score for hip function and HSS score for knee function significantly increased compared with those before operation(P<0.05). By the time of the latest follow-up, all patients got bony fracture healing, with healing time of(5.93±1.22) months on average. [Conclusions] This bridging system fixation combined with decortication does achieve satisfactory clinical outcomes for treatment of femoral shaft nonunion.

关 键 词：骨不连 桥接系统 内固定 去皮质 自体植骨 

分 类 号：R683.42[医药卫生—骨科学]