22例胫骨骨折骨不连的原因及治疗

The causes and treatment of 22 cases with complex non-union fractureof the tibia

２２例胫骨骨折骨不连中，开放性骨折１７例，闭合性骨折５例，均为高能量损伤。骨不连类型：折端肥大型１５例，萎缩型７例，并有皮肤大面积瘢痕形成。骨不连的原因：肥大型骨不连主要是骨折固定不牢所致；萎缩型骨不连主要是开放性骨折局部骨丢失，软组织损伤重以及感染形成局部血循不良，无成骨能力所致。折端肥大型骨不连采用铁轨式髓腔棒牢固内固定（联锁或不联锁）；萎缩型骨不连采用植骨和伊凡洛夫外固定器固定均获成功。平均随访１４．２个月，骨折愈合期为４～８个月。成功的原因与加强了骨折固定和改善了骨折的血供密切相关。

cases open fracture and 5 cases closed fracture in 22 cases of tibial fracture with non-unionwere caused by high-energy injury. Fifteen of the non-unions were hypertrophic and seven were atrophic.There were large areas of scar formation in the Iower legs,As to the causes of the non-unions:the hyper-trophic non-unions were caused mainly by unstable fixation;the atrophic non-unions were caused mainly bythe bone loss at the open fractures,severe soft tissue injury,bad blood circulation after infection and loss ofossification ability. The hypertrophic non-unions were treated by locked and unlocked intramedullarynails;the atrophic non-unions were treated by iliac graft and Ilizarov external fixation,All non-unions werehealed.he mean follow up time was 14. 2 months. The healing period was 4-8 months.The causes of theeventual healing were strengthening of fracture fixation and improvement of blood circulation to the frac-tured parts.