四肢长骨骨折骨不连的原因和手术治疗探讨

目的：研究分析四肢长骨骨折骨不连的原因和手术治疗效果。方法选取该院2012年4月—2013年5月间收治的50例四肢长骨骨折骨不连患者，对其骨不连的原因进行分析，并进行手术治疗，采取内固定和自体髂骨取骨植骨术治疗，观察手术治疗的效果。结果对所有患者均进行随访，随访时间为4~17个月，所有患者再次手术后伤口均一期愈合，骨折部位均骨性愈合，骨折愈合时间为5~10个月。术后随访复查X线片显示：所有患者在2个月左右骨折端有新的骨痂生成，3~4个月有连续骨痂生成，6~8个月骨折达到临床愈合。另外，所有患者手术治疗的平均时间为（32.58±15.69）min，在术中平均出血量为（22.14±5.67）mL。结论四肢长骨骨折骨不连的原因有多方面，其中伤情严重和医源性因素是造成骨不连的主要因素。通过使用手术去除硬化骨，并打通髓腔，加强固定和植骨手术治疗可以取得较好的效果。

The Reason of the Nonunion of Long Bone Fracture of Extremities and Cor-responding Surgical Treatment

Objective To study and analyze the causes of nonunion of long bone fracture of extremities and the effect of corre-sponding surgical treatment. Methods 50 patients with nonunion of long bone fracture of extremities admitted in our hospital from April 2012 to May 2013 were selected. The reasons that caused the nonunion were analyzed. The patients were given the surgical treatment, internal fixation and autologous iliac bone grafting. And the therapeutic effect of operation was observed. Results All the patients were followed up for 4-17 months. The wound of all the patients was healed by first intention after the second operation. The fracture sites were bony healing, the healing time was 5-10 months. Postoperative X-ray showed that all of the patients had new callus growing at the fracture end in the period of 2 months or so, continuous bone callus growing in 3-4 months, in 6-8 months the fracture healed clinically. In addition, the average time of operation treatment for all patients was （32.58 ±15.69） min, the mean intraoperative blood loss was （22.14±5.67） ml. Conclusion There are many reasons that can cause the nonunion of long bone fracture of extremities, of which, severe injury and iatrogenic factors are the main reasons. By operation removing the sclerotic bone and getting through the medullary cavity, strengthening fixation and bone grafting operation treatment can achieve good results.