交锁髓内钉固定股骨干骨折术后骨不连原因分析

目的探讨股骨干骨折应用交锁髓内钉固定术骨不连的原因,并提出防治措施。方法对南昌大学第三附属医院2009～2010年34例采用交锁髓内钉治疗股骨干骨折患者进行回顾性分析,其中对6例骨延迟愈合及3例骨不连者采取骨折端动力化,对1例骨不连者行取钉、更换内固定并植骨。结果骨延迟愈合6例骨延迟愈合及4例骨不连者,经过上述治疗,随访10个月以上,骨折愈合良好。结论静力交锁髓内钉固定的股骨骨折愈合主要通过膜内骨化,术中应避免损伤骨膜,适时采取骨折端动力化,促进软骨内骨化,减少术后骨不连。

Causes analysis of postoperative nonunion of femoral shaft fracture treated with intramedullary interlocking nail

Objective To investigate the causes of postoperative complications of femoral shaft fracture treated with intramedullary interlocking nails.Methods A total of 34 patients with femoral shaft fractures admitted to our hospital from 2009 to 2010 were retrospectively studied.They were all treated with intramedullary interlocking nails.The locking nails were removed from 6 patients with delayed union and 3 patients with nonunion to dynamize the fracture.For 1 patient with bone nonunion,the intramedullary interlocking nails was removed,and a larger one and bone grafts were applied.Results Followed up for more than 10 months,the fractures of 6 patients with delayed union and 4 patients with nonunion were completely healed.Conclusions The femoral shaft fracture healing treated with intramedullary interlocking nails depend mainly on intramembranous ossification so that periosteum invasion should be avoided during operations.Dynamization of the fracture in time can promote endochondral ossification.