髂骨瓣钢板内植骨有限内固定置入结合外固定支架治疗肱骨术后骨不连13例

背景：对于肱骨骨折术后骨不连至今尚无十分有效完善的方法。髂骨钢板的应用不仅可以保持骨折端与植骨块的紧密接触，促进骨折的愈合；还可以为骨折愈合提供良好的稳定性，提供更加坚强的固定。 目的：观察应用髂骨钢板植骨有限内固定置入结合外固定支架治疗肱骨骨折术后骨不连的临床效果。 方法：选择解放军济南军区总医院骨创伤外科收治的肱骨骨折术后骨不连患者13例，男11例，女2例；年龄20~51岁，平均年龄35.5岁；全部患者采用髂骨钢板植骨有限内固定结合外固定支架治疗。X射线平片观察骨愈合情况；肩关节功能采用Neer评分进行评定，及有无并发症发生。 结果与结论：13例患者均获得随访，随访时间7~64个月，平均随访38个月。全部患者原骨不连处均在6~10个月(平均8.1个月)内完全愈合；所有患者肩肘关节活动功能正常，术后半年Neer评分71~96分，平均87分。无感染及患肢疼痛等并发症，无再发骨折及骨不连发生，肩肘关节功能均得到恢复。提示髂骨钢板植骨有限内固定结合外固定支架固定治疗肱骨骨折术后骨不连是一种十分合理、安全、可靠和有效的方法。

Treatment of humerus nonunion using iliac bone graft limited internal fixation combined with external fixation in 13 cases

BACKGROUND: There is lack of effective method for treating humerus nonunion. Iliac plate can maintain the compact contact between fracture end and bone graft, accelerate bone union, as well as provide stability for bone union. OBJECTIVE: To evaluate the clinical effects of treating humerus nonunion by using iliac bone graft as plate combined with the external fixation. METHODS: Thirteen patients with nonunion of the humorous at Department of Orthopedic Trauma Surgery, Jinan Command General Hospital of Chinese PLA were selected, including 11 males and 2 females, aged 20-51 years, mean aged 35.5 years. All the patients were treated with iliac bone graft and screws combined with the mono lateral external fixation. The bone healing was observed by X-ray film. Shoulder function and complications were measured by Neer score. RESULTS AND CONCLUSION: All patients were followed up for 7-64 months, mean 38 months. Bony union was achieved in all patients within 6-10 months (mean 8.1 months). The activity function of shoulder and elbow was normal; and Neer scores were 71-96 (mean 87 scores). No infection, pain, prevalent fracture or nonunion occurred. The results demonstrated that using iliac bone graft as plate combined with the mono lateral external fixation is a good salvage operation for nonunion of the humerus.