交锁髓内钉治疗股骨、胫骨不愈合及延迟愈合

目的分析导致股骨、胫骨不愈合和延迟愈合的原因,探讨使用交锁髓内钉治疗的临床效果。方法回顾我院自1999年1月～2004年6月应用扩髓交锁髓内钉治疗下肢长管状骨骨折不愈合及延迟愈合患者16例,其中股骨5例,胫骨11例;钢板内固定术后,股骨2例,胫骨4例;普通髓内钉固定术后,股骨1例;带锁髓内钉固定,股骨1例;石膏外固定,胫骨3例;外固定架固定,股骨1例,胫骨4例。均采用有限切口切开复位顺行扩髓,静力锁定加植骨治疗。结果所有病例均获随访,时间为11～24个月(平均16.5个月),骨折均达到骨性愈合,愈合时间7～23个月。结论交锁髓内钉 植骨治疗股骨、胫骨骨折不愈合及延迟愈合具有固定牢靠、利于关节早期活动、植骨的成骨作用可促进骨愈合等优点,值得推荐使用。

Interlocking nail in treatment of non-union and delayed union of femoral and tibia shaft fractures

Objective To investigate the causes of non-union and delayed union of femoral and tibia shaft fracture, and to explore the effectiveness of non-union and delayed union of femoral and tibia shaft fractures treated with reamed intramedullary interlocking nail.Methods Since January ,1999 to June, 2004, 16 cases with non-union and delayed union of femoral and tibia shaft fractures had treated with a reamed intramedullary interlocking nail. Of 16 cases, 5 were femoral shaft fractures and 11 tibia shaft fractures, In primary treatment 2 cases of femoral shaft fractures and 4 cases of tibia shaft fractures were fixed by plate, 1 case of femoral shaft fracture was fixed by common intramedullary nail, 1 case of femoral shaft fracture was fixed by reamed intramedullary interlocking nail, 3cases of tibia shaft fractures were fixed by plaster, 1 case of femoral shaft fracture and 4 cases of tibia shaft fractures were fixed by external fixator. All cases were treated by a limited open reduction, fixation of reamed intramedullary interlocking nail and bone graft.Results All cases were followed up from 11 to 24 months (average 16.5 months), and all healed up well within 23 months.Conclusion The use of reamed intramedullary interlocking nail and bone graft are successful in the treatment of femoral and tibia shaft fractures of non-union and delayed union. The nail can provide enough stabilization for the fracture site, and the fracture heals rapidly, good recovery of function, and it is a recommen method for promoting bone-healing up after grafting and forming.