股骨干骨不连 更换髓内钉后发生不良后果的危险因素

年龄、性别、骨折类型、髓内钉锁钉技术以及植骨等因素,并未表现出会对骨愈合、平均愈合时间或二次手术的必要性产生影响.对于吸烟这一预后因素的研究结果也互为矛盾.有研究发现,非吸烟者比吸烟者更容易达到骨愈合.然而,另两项研究的结果却显示,非吸烟者的平均愈合时间和需行二次手术的可能性并未显著降低.以往对于不同预后因素的影响效力的研究,其说服力仍显不足.对于更换髓内钉治疗股骨干骨不连的临床结果,有必要进行更为严格的方法学多中心预后研究,以提供更大的样本量和描绘不同预后因素的影响作用.

Femoral shaft nonunions:risk factors for poor outcome following exchange nailing

Age, gender, fracture type, nail locking technique, and bone grafting did not appear to affect union, mean time to union, or need for additional procedures. Evidence on smoking as a prognostic factor was conflicting. Nonsmokers were more likely to achieve procedure compared with smokers in one union after one study. However, the mean time to union and need for additional procedures were not decreased in nonsmokers in two other studies. Studies may have had insufficient power to detect the effects of various prognostic factors. A methodologically rigorous multi-center prognostic study may provide a larger sample size, and help delineate factors affecting outcome in exchange nailing for the treatment of femoral shaft nonunion.