冲击波治疗四肢骨折内固定术后骨不连的临床分析

目的 探讨体外冲击波治疗四肢骨折内固定术后骨不连的机理和疗效.方法 对21例有切开复位＋内固定或外固定支架固定手术史患者（其中带锁髓内钉内固定6例,钢板内固定8例,记忆合金环抱器内固定4例,外固定支架固定3例;尺骨骨折2例,肱骨骨折4例,股骨骨折6例,胫骨骨折9例）.均采用体外冲击波治疗2～3次.结果 所有患者均获随访,经2次体外冲击波治疗后21例中16例获得骨折愈合,治疗3个月无明显骨痂生长5例,再行第三次体外冲击波治疗,2例获得骨折愈合,最终成功18例,治愈率为85.7%.2例患者出现局部表浅皮肤破损,治疗中未观察到神经、血管损伤等并发症.结论 体外冲击波治疗骨不连具有创伤小、并发症少、费用低、无需住院、疗效确切等优点,对促进骨不连愈合有较好的作用,临床治疗效果满意.

Treatment of nonunion of limbs fracture after internal fixation with extracorporeal shock wave

Objective To explore the mechanism and effect on treatment of nonunion of limbs fracture after internal fixation with extracorporeal shock wave. Methods Twenty-one cases of 20 patiems were treated with surgical operation. Among them,6 cases were treated with intramedullary nailing; 8 cases were treated with plate; 4 cases were treated with memory alloy embracing fixator; 3 cases were treated with external fixator. There were 2 cases of ulnar fracture,4 cases of humeral fracture, 6 cases of femoral fracture and 9 cases of tibial fracture. All cases were treated 2 ~ 3 times with extracorporeal shock wave. Results All cases were followed up. Sixteen cases were cured with extra- corporeal shock wave. In 5 cases who had not bone growth after 3 months, 2 cases were cured with extracorporeal shock wave again. 18 case of all patients were cured with extracorporeal shock wave. Cure rates of them were 85.7%. There were 2 cases of skin injury. There were not damage of nerve and blood vessel. Conclusion The technique of extracorporeal shock wave has advantages of minimally invasive, less complications, low expenses, no hospitalization and true effects. It could promot the bone healing. We could acquire satisfied curative effects in treatment of nonunion of limbs fracture after internal frxation with extracorporeal shock wave.