抗感染重组合异种骨植入治疗四肢骨折内固定术后骨不连

目的探讨抗感染重组合异种骨(ARBX)植骨治疗四肢骨折内固定术后骨不连的临床疗效。方法取除原内固定、重新内固定或外固定,并应用抗感染重组合异种骨植入治疗四肢骨折内固定术后骨不连20例,全部为无菌性骨不连。断端应用ARBX植骨20例,混合自体髂骨移植9例。结果20例随访1年2个月～4年2个月,平均2年8个月。20例应用ARBX植骨治疗的骨不连中,18例完全愈合,1例延迟愈合,1例未愈合。无1例骨感染发生。结论重新内固定或外固定,避免了原手术方式存在的引起骨不连的内在因素;ARBX植骨治疗骨不连安全,对促进骨愈合疗效可靠。

Treatment of Bone Nonunion after Internal Fixation of Limb Fracture with Anti - infective Reconstituted Bone Xenograft

Objective To investigate the clinical outcome of anti-infective reconstituted bone xenograft (ARBX) in the treatment of bone nonunion after internal fixation of limb fracture.Methods Twenty cases of the bone nonunion after the internal fixation of limb fracture were treated with the debridement,removal of the original internal fixation,fixation with the new internal or external fixators and with the anti-infective reconstituted bone xenograft grafting.Results The followed-up period ranged from 1 year and 2 months to 4 years and 2 months with an average of 2 years and 8 months.There was no recurrence of infection.One case had bone nonunion, one case had delayed bone union and the other cases had complete bone union.Conclusion The fixation with the new internal or external fixators can avoid the internal factor of the existence of the original internal fixation that causes the bone nonunion.It is safe to treat the bone union and reliable to accelerate the bone healing with the anti-infective reconstituted bone xenograft.