胫骨骨折术后骨不连30例原因与疗效分析

目的分析胫骨骨折术后骨不连发生的原因与治疗效果。方法自1989年1月～2003年12月共收治胫骨骨折术后骨不连30例，其中22例采用有限接触钢板内固定 自体髂骨植骨术，4例采用外固定支架固定，4例采用带锁髓内钉内固定 植骨固定。结果术后平均随访14个月(8月～3年)，未发生骨髓炎等并发症。经X线片检查，骨折均骨性愈合，其中6～12月愈合17例，12～18个月愈合11例，大于18个月愈合2例。结论骨折区段的血供、内固定材料、操作技术三大综合因素是造成骨不连的主要原因。自体髂骨植骨加可靠内固定是治疗的重要方法。

Analysis of Pathogenesis and Therapeutic Effect of Postoperative Nonunion of Tibial Fracture (with A Report of 30 Cases)

Objective To analysis the pathogensis and th er apeutic effect of postoperative nonunion of tibial fracture. Methods 30 cases of tibial fracture admitted from January 1989 to December 2003 were enrolled into study,of which 22 cases underwent limited contac t internal fixation with steel plates,4 cases underwent external stand f ixation, 4 cases underwent internal fixation with interlocking intramedullary na il and bone graft. Result Union were demontrated in all cases by x-ray with 8 months to 3 years follow-up (average 14 months) of whic h union in 6 to 12 months in 17 cases, 12 to 18 months in 11 cases, over 18 mont hs in 2 cases. Conclusion Bone nonunion is caused by com prehensive factors including blood supply, internal fixation materials and opera ting technique. Autoimplantation of iliac bone combined with definite internal f ixation can be regarded as an important treatment.