双钢板技术结合自体髂骨植骨治疗髓内钉术后股骨骨不连

目的:探讨双钢板结合髂骨植骨治疗髓内钉术后股骨骨不连的临床效果.方法:2008年12月至2017年12月应用双钢板结合自体髂骨植骨治疗髓内钉术后股骨骨不连患者11例,男10例,女1例;年龄35～62岁;骨折至骨不连时间12～20个月.根据Judet分类法分型:萎缩型骨不连8例,增生型骨不连3例.术后定期随访,记录患者骨...

Effect of double plate technique combined with autogenous iliac bone graft in the treatment of femoral nonunion after intramedullary nailing

Objective: To investigate the clinical effect of double plate combined with iliac bone graft in the treatment of femoral nonunion after intramedullary nailing.Methods: From December 2008 to December 2017,double plate combined with autogenous iliac bone graft was used to treat femoral nonunion after intramedullary nailing. There were 11 cases,including 10 males and 1 female,aged 35 to 62 years,and the time from fracture to nonunion was 12 to 20 months. According to Judet classification,there were 8 cases of atrophic nonunion and 3 cases of proliferative nonunion. Regular follow-up was conducted after operation to record the fracture healing time,load-bearing activity time and complications,and to observe the repair effect of double plate fixation combined with iliac bone graft on nonunion after femoral shaft fracture operation.Results: All patients were followed up for 12 to 22 months. The operation time was 70 to 130 min and the blood loss was 180 to 350 ml. After operation,2 cases had knee stiffness,which recovered after passive exercise with CPM machine for 2 weeks;1 case had pain in iliac bone donor area,which was relieved after 3 months. The time of fracture healing was 24 to 40 weeks,and the time of complete weight-bearing activity was 14 to 32 weeks. SF-36 quality of life score at the final follow-up:body pain 70 to 82,activty 70 to 82,social function 72 to 83,the overall health 72 to 82. At the end of the follow-up,there were no complications such as limb shortening,infection,poor wound healing,internal fixation failure (fracture,loosening).Conclusion: It is an effective method to treat nonunion of femur after intramedullary nailing by using double plate combined with autogenous iliac bone graft.