锁定加压钢板单骨皮质固定治疗长骨骨折髓内钉术后骨不连

目的 探讨应用锁定加压钢板(LCP)单骨皮质固定治疗长骨骨折交锁髓内钉同定术后骨不连的方法及疗效.方法 2004年7月至2007年3月,对8例股骨或胫骨骨折交锁髓内钉固定术后确诊为骨不连的患者,不取髓内钉,应用LCP穿透一侧骨皮质同定、断端切新并取自体骼骨植骨治疗,病程12.28个月,平均19.8个月.术后7 d开始部分负重,6个月后完全负重.结果 8例患者术后获8～20个月(平均14个月)随访.骨折断端术后6个月出现明显骨痂,8～16个月牢同连接,平均愈合时间12.6个月,无置入物松动等并发症发生.结论 对于交锁髓内钉固定后骨不连时间较长的患者,采用LCP穿单侧骨皮质固定、断端切新并取自体髂骨植骨治疗,具有方法简便、损伤小、花费少、疗效确实等优点.

Unicortical fixation with locking compression plate for treatment of long bone nonunion following intramedullary nailing

Objective To investigate the effects of locking compression plate(LCP)used in unicortical fixation for treating nonunion of long bone fracture following intramedullary nailing.Methods From July 2004 to March 2007, 8 cases of long bone nonunion after intramedullary nailing were treated with unicortical LCP fixation and iliac bone graft, without removal of intramedullary nails.The treatment lasted 12 to 28(mean, 19.8)months.Results All cases were followed up for 8 to 20(mean, 14)months.Bony callus appeared at the broken ends of fracture 6 months after the operation.Firm unions were obtained within 8 to 16(mean, 12.6)months, and no such complications as loosening of inserts were found.Conclusions LCP unicortical fixation and iliac bone graft can be applied for patients suffering from long bone nonunions after failed intramedullary nailing.The advanced locking design of the plate can allow the patients to achieve satisfactory healing when walking naturally.