带锁髓内钉固定并植骨治疗陈旧性股骨干骨折

目的 评价带锁髓内钉并植骨治疗股骨干陈旧性骨折的临床疗效和优点。方法 对1996年2月～2003年11月收治的47例陈旧性股骨干骨折患者进行回顾性分析。其中植骨组28例，非植骨组19例。采用切开复位，带锁髓内钉扩髓，静力型固定，根据骨折部位生长情况改为动力型固定。结果 术后随访39例，随访lO～25个月，平均随访时间14．2个月。植骨组骨折愈合率为95．6％(22／23)，感染率为4．3％(1／23)，骨折平均愈合时间为6．3个月，非植骨组则分别为62.5%(10／16)，6．25％(1／16)和9．7个月。临近关节功能达正常，无感染、断钉等并发症。结论 带锁髓内钉静力固定能有效控制有害的剪应力，同时对骨折有一定的加压作用，可提供早期坚强的内固定，同时，植骨后骨折愈合快，并发症少，是治疗陈旧性骨折的理想方法。

Interlocking intramedullary nailing and bone grafting in treatment of old fractures of femoral shaft

Objective To evaluate effects of the treatment of old fractures of femoral shaft wit h interlocking intramedullary nailing and bone gra fting.Methods A retrospective study was carried ou t for 47patients with old fracture of femoral shaft who were tr eated from February 1996to November2003in our hospital.28of them underwent bone grafting(group A),while 19no bone grafting(group B ).All the cases were manipulated by op en reduction and static fixation with intramedullary interlocking nails after marrow cavity reamed.The static fixation was changed to the dynamic fixation depending on the healing of the fracture after surgery.Results The mean follow-up was 14.2months(10to 25months)in 39cases.The healing rate and the i nfection rate were 95.6%(22/23)and 4.3%(1/23)re-spectively in group A with a mean healing time of 6.3months,while those in group B were 62.5%(10/16)and 6.25%(1/16)respectively with a mean healing tim e of 9.7months.The fractures all healed up,the joint function recovered well,and there were no complication s in this series.Conclusions Intramedullary interlocking nails and the static fixation can not only effectively co ntrol harmful shear stress but also e xert more pressure on fractures to pr ovide early firm internal fixation.The interlockin g intramedullary nailing and one sta ge bone grafting can accelerate fracture healing and reduce complications.So it is a perfect procedure for patients with old f racture of femoral shaft.[