肱骨干骨折术后不愈合的原因分析及治疗

目的 通过治疗并随访肱骨干骨折术后不愈合患者,分析骨折不愈合的原因,探讨肱骨干骨折正确的治疗方法.方法 2005年1月至2008年12月收治肱骨干骨折术后不愈合患者25例,手术取出原内固定物,诊断端清理、髓腔再通、自体髂骨植骨及重新内固定(锁定加压钢板21例,重叠双钢板3例,交锁髓内钉1例).结果 25例患者均获骨性愈合;肩关节功能优良率88%(22例),肘关节功能优良率92%(23例).结论 肱骨骨折术后不愈合的常见原因为创伤重、术中操作及内植物选择不当、功能锻炼不规范.锁定加压钢板加自体松质骨植骨是治疗肱骨骨折术后不愈合的有效方法.

Causes and treatment of nonunion of humeral shaft fracture

Objective To analyze the etiology of nonunion of humeral shaft fractures and to expioreits treatment. Methods Twenty-five cases with nonunion postoperative humeral shaft fractures, who performed cleaning fracture ends,marrow recanalization, bone grafting and fix, were analyzed retrospectively. Results After open reduction, internal fixation and bone grafting of iliac bone were bone healing; the excellent and good rate of shoulder joint function was 88% (22 cases)and 92% (23 cases) ,in elbow joint. Conclusions The main reasons of nonunion of humeral shaft fracture are heavy injury ,improper operation and unsuitable training. Using locking compressing plate supplemented with autogenous cancellous bone graft is an effective treatment of nonunion of humeral shaft fracture.