交锁髓内钉结合锁定板治疗股骨干骨折钢板内固定术后非
感染性骨不连
黄玉成;焦竞;程文俊;王昕;王俊文
【期刊名称】《中华实验外科杂志》 【年(卷),期】2017(034)008
【摘要】目的 探讨交锁髓内钉结合侧方锁定板治疗股骨干骨折钢板内固定术后非感染性骨不连的临床疗效.方法 分析收治并获得完整随访的17例股骨干骨折钢板内固定术后非感染性骨不连患者的资料,治疗采用交锁髓内钉结合侧方锁定板固定.术后1、3、6、12个月及以后每年定期复查,通过影像学分析骨折愈合情况,并指导患肢功能锻炼.结果 17例患者术后获14~36个月(平均19.6个月)随访,骨不连均愈合,愈合时间为6~14个月,平均8.7个月.术前患肢美国骨科学会(AAOS)评分、肢体短缩长度、膝关节屈曲及伸直角度分别为(68.5±10.1)分、(0.2±0.8)cm、(92.4±13.7)°和(1.8±5.0)°.术后12个月各项指标依次为(88.7±5.0)分、(0.6±0.9)cm、(110.9±15.0)°和(0.6±4.6)°.术后12个月AAOS评分及膝关节屈曲角度分别与术前比较均有明显改善(t=7.339,P=0.000;t=3.757,P=0.001).术后12个月肢体短缩长度及膝关节伸直角度分别与术前比较,差异无统计学意义(t=1.572,P=0.126;t=-0.713,P=0.481).无严重并发症发生.结论 交锁髓内钉结合侧方锁定板是治疗股骨干骨折钢板内固定术后非感染性骨不连的有效方式.%Objective To discuss the clinical effect of intramedullary nail with augmentation locking plate in treatment of aseptic
nonunion
of
femoral
shaft
fracture
after
plate
osteosynthesis.Methods From March 2011 to March 2016,17 patients
with aseptic nonunion of femoral shaft fracture after plate osteosynthesis were treated with interlocked intramedullary nail assisted by locking plate.Patients were evaluated by radiographic imaging and clinical function at 1st,3rd,6th,and 12th month and then every year after surgery,to observe the callus and the recovery of the affected limb function.Results All 17 cases were followed up for average 19.6 months (range: 14 to 36 months),and all nonunions were healed.The average radiographic bony union time was 8.7 weeks (range: 6 to 14 weeks).The American Society of Department of Orthopedics (AAOS) scores,leg length discrepancy (LLD),flexion and extension angles of preoperation were (68.5±10.1) scores,(0.2±0.8) cm,(92.4±13.7)° and (1.8±5.0)°,respectively.The above four indices of postoperation at 12 months
were
(88.7±5.0)
scores,(0.6±0.9)
cm,(110.9±15.0)°and
(0.6±4.6)°,respectively.The AAOS scores and flexion motion were improved
after
surgery
(t=7.339,P=0.000;t=3.757,P=0.001,respectively).There was no significant difference in either the LLD or extension angle after operation (t=1.572,P=0.126;t=-0.713,P=0.481,respectively).No complications
occurred.Conclusion
Fixation
with
serious interlocked
intramedullary nail assisted by locking plate is an ideal treatment for aseptic nonunion of femoral shaft fractures after plate osteosynthesis. 【总页数】3页(1411-1413)
【关键词】股骨骨折;不愈合;植骨术;骨折固定术 【作者】黄玉成;焦竞;程文俊;王昕;王俊文
【作者单位】430033 武汉,华中科技大学同济医学院附属普爱医院骨科;430033 武汉,华中科技大学同济医学院附属普爱医院骨科;430033 武汉,华中科技大学同济医学院附属普爱医院骨科;430033 武汉,华中科技大学同济医学院附属普爱医院骨科;430033 武汉,华中科技大学同济医学院附属普爱医院骨科 【正文语种】中文 【中图分类】 【文献来源】
https://www.zhangqiaokeyan.com/academic-journal-cn_chinese-journal-experimental-surgery_thesis/0201234716545.html 【相关文献】
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交锁髓内钉结合锁定板治疗股骨干骨折钢板内固定术后非感染性骨不连
