中国骨伤2023，Vol.36Issue(12)：1191-1195,5.DOI:10.12200/j.issn.1003-0034.2023.12.016
附加锁定钢板并植骨治疗保留髓内钉的下肢长骨干骨折不愈合
Augmenting locking plate with autologous bone graft for the treatment of nonunion of long bone fracture in the lower extremity with retaining of the original intramedullary nail
王圣睿 1于进洋 2王瑜豪 1王培召 2谭红略2
作者信息
- 1. 河南中医药大学,河南 郑州 450046
- 2. 河南省洛阳正骨医院河南省骨科医院膝关节外科中心,河南 洛阳 471002
- 折叠
摘要
Abstract
Objective To explore clinical effect of attaching locking plate with bone grafting based on retaining the original intramedullary nail in treating non-union after intramedullary nail fixation of long shaft fractures of lower limbs.Methods A retrospective study was conducted on 20 patients treated with non-union fractures after intramedullary nailing of long shaft frac-tures of lower limbs from June 2015 to June 2020.All patients were treated with the original intramedullary nailing and bone grafting from the iliac bone,and were underwent open reduction plate internal fixation and bone grafting for old fractures.A-mong them,14 were males and 6 were females,aged from 35 to 56 years old with an average of(42.2±9.6)years old.Nine pa-tients were femoral shaft fracture and 11 patients were tibial shaft fracture.According to characteristics of fracture end nonunion,6 patients were stable/atrophic,9 patients were unstable/large,and 5 patients were unstable/atrophic.The nonunion time ranged from 8 to 12 months with an average of(9.8±2.0)months after the initial surgery.Visual analogue scale(VAS),knee range of motion,bone healing time,complications and fracture-end healing were recorded before and at the latest follow-up.Results All patients were followed up for 18 to 48 months with an average of(36.3±10.5)months.The incision of all patients were healed at stage Ⅰ without complications such as infection or internal fixation ruptur.Healing time of femur and tibia was(8.5±2.6)months and(9.5±2.2)months.Knee joint motion increased from preoperative(101.05±8.98)° to postop-erative(139.35±8.78)° at the latest follow-up(t=-1 2.845,P＜0.001).VAS decreased from preoperative(5.15±1.72)to post-operative(0.75±0.96)at the latest follow-up(t=1 1.186,P＜0.001).Conclusion On the basis of retaining the original in-tramedullary nail,the addition of locking plate internal fixation and autogenous iliac bone grafting have advantages of simple operation,less trauma,fewer complications and high fracture healing rate.It is one of the effective surgical schemes for the treatment of nonunion after intramedullary nail fixation of long bone fracture of lower extremity.关键词
股骨干骨折/胫骨干骨折/骨折不愈合/髓内钉/锁定钢板/植骨Key words
Femoral shaft/Tibial shaft/Bone nonunion/Intramedullary nail/Locking plate/Bone graft分类
医药卫生引用本文复制引用
王圣睿,于进洋,王瑜豪,王培召,谭红略..附加锁定钢板并植骨治疗保留髓内钉的下肢长骨干骨折不愈合[J].中国骨伤,2023,36(12):1191-1195,5.
