可膨胀髓内钉结合自体骨移植治疗肱骨干骨不连

目的探讨可膨胀髓内钉FixionTM系统结合自体骨移植在肱骨干骨不连中的应用和临床疗效方法对11例肱骨干中1/3骨折骨不连病人采用可膨胀髓内钉FixionTM系统结合自体骨移植进行治疗,8例有钢板内固定手术史,其中2例骨质明显疏松,1例存在桡神经麻痹。结果手术时间63~115min（平均87min）;术中出血量120~250ml（平均180ml）;11例骨不连均痊愈（平均愈合时间17周）。结论可膨胀髓内钉FixionTM系统结合自体骨移植是治疗肱骨干骨折骨不连比较理想的方法,尤其适用于骨质疏松病人。

Treating humeral shaft nonunions using expandable intramedullary nail Fixion TM with autologous bone grafting

Objective To report the technique and clinical results of the expandable intramedullary nail FixionTM with autologous bone grafting for humeral shaft nonunions. Methods Between August 2004 and Nov 2006 ,11 patients with humeral shaft nonunions treated with expandable intra-medullary nail system FixionTM with autologous bone grafting were analyzed retrospectively ,including 6 male and 5 female from 23 to 64 years old. Results The surgical time ranged from 63min-115min(87min in average )and blood loss from 120-250ml (180ml in average), the follow up lasted 15 months in average and the fracture healing time was 17 weeks in average. Conclusions By using the expandable intramedullary nail system, highly resistant to the rotational strength is achieved due to the "hour-glass" anatomical character ,and it is a minimal invasive insertion technique which can significantly reduce the surgical time and the fluoroscopic time. Due to the abutment of the longitudinal bars along the entire length of the medullary canal ,the fracture healing time can be decreased. The Fixation expandable intramedullary nail with autologous bone grafting provides many advantages to conventional interlocking. IM nail in treatment of humeral shaft nonunions, especially in patients with osteoporosis when used for the correct indication and with proper surgical technique.