前臂骨折术后骨不连原因分析及治疗对策

目的分析前臂骨折手术后引起不愈合的影响因素,以期提高手术治疗前臂骨折的愈合率,减少再次手术。方法对23例前臂骨折术后不愈合病例的手术固定方法、术后处理及二次手术方法进行回顾性分析,探寻影响前臂骨折愈合的内在及外在因素。结果前臂骨折术后引起骨折不愈合的主要原因:内固定方法不当8例,感染6例,粉碎性骨折未能早期植骨5例,术后功能锻炼不当2例,术后再次外伤2例。所有病例第二次手术后均获得骨性愈合,无感染、内固定物折断等并发症发生。结论在前臂骨折术后发生骨不连的众多原因中,医源性因素仍占大部分。选取合适的固定方法、及时植骨、术后正确处理等是预防前臂骨折术后不愈合、恢复前臂功能的主要手段。

Nonunion of the Forearm: An Analysis of Contributing Factors and Therapeutic Strategy

Objective To analyze various factors of severe malunion and nonunion of forearm fractures and improve the healing rate after operation and reduce the rate of reoperation.Methods 23 patients with postoperative forearm fractures were retrospectively analyzed to identify the relationship between operation,postoperative treatment,reoperation,and nonunion.Results The causes of malunion and nonunion consisted of unsuitable treatment in 8 patients,infection in 6 patients,syntripsis without timely bone graft in 5 patients,unsuitable functional exercise in 3 patients,and reinjury in 2 patients.Postoperatively,all the fractures achieved synostosis without any complication.Conclusion Due to the anatomical features of ulna and radius,forearm osteoclasis has a higher rate of nonunion or delayed union.However,iatrogenic factors play an important part in nonunion or delayed union.To reoperate with suitable fixing materials,bong grafting and correct postoperative nursing is the effective method to treat nonunion of postoperative forearm fractures.