外固定支架加压牵开联合加压治疗长管状骨非感染性不愈合的临床研究

目的探析临床采用外固定支架加压牵开联合加压治疗长管状骨非感染性不愈合的治疗效果。方法选择我院2009年3月至2011年9月收治的9例长管状骨非感染性不愈合患者作为研究对象,通过外固定支架加压牵开联合加压对患者进行治疗,观察病例的愈合情况。结果其中2例胫腓骨不愈合患者发生针道深部松动、感染导致对位异常,应用抗生素以及外固定架加压牵开联合加压治疗后愈合。3例股骨干不愈合的患者在进行第二次加压治疗时向后成角、内翻。其余4例患者仅仅出现了轻微的针道并发症,经过临床医师及时合理的对症治疗后愈合。9例患者经过治疗后骨折均愈合,愈合时间6~12个月,平均(8.1±1.8)个月,患者带架时间6~18个月,平均(12.3±2.5)个月,患者拆除外周支架后随访1~12月未见有骨折发生。结论临床上对于良好接触面积、未合并肢体长度异常、骨折端形态适宜于加压的长管状骨肺感染性骨折不愈合患者采用外固定支架加压牵开联合加压疗法进行治疗能有效地减少术中出血量和剥离不愈合端,避免进行植骨治疗。

Clinical Studies of External Fixator Pressurized to Retractor Joint Compression Therapy Long Tubular Bone Nonunion Noninfectious

Objective Probe into clinical use external fixator pressurized to retractor joint pressure treatment of long bone nonunion treatment of non- infectious effect. Methods 9 cases in our hospital from March 2009 to September 2011 were treated nonunion long bone non-infectious patients as research subjects, through the external fixator pressure the retractor joint pressure to treat patients, observed cases healing. Result Two cases of the tibia and fibula not healing needle tract occurs in patients with deep loosening, infection could cause abnormal alignment, the use of antibiotics as well as the external fixator pressurized retractor joint compression therapy and healing. 3 cases of femoral shaft nonunion patients during the second compression therapy backward angled varus. The remaining four patients, there had been only minor needle tract complications, healing after clinicians in a timely and reasonable symptomatic treatment. 9 patients after treatment fracture healing, the healing time of 6 to 12 months, an average of （8.1±1.8） months, patients with rack time 6 to 18 months, an average of （12.3±2.5） months, patients dismantle peripheral stents were followed up for 1 to 12 months no fracture occurred. Conclusion The clinical good contact area, unconsolidated abnormal limb length, fracture morphology suitable for long bone lung infection pressurized nonunion were treated with external fixator retractor pressure the joint compression therapy treatment can effectively reduce blood loss and stripping nonunion end, to avoid graft in treatment.