股骨干骨折内固定治疗失败原因分析

Causes of failure in internal fixation used for femoral shaft fractures

分析５１例股骨干骨折切开复位内固定术后发生畸形愈合、延迟愈合及不愈合的原因，结果表明：除内固定运用不当，粉碎骨折未一期植骨固定、术后过早负重外，术后未能配合必要外固定、不能正确进行功能锻炼、膝关节功能障碍及手术创伤也是导致治疗失败的重要原因。结论：骨折正常愈合，关键在于维持骨折稳定并使其免受不利应力干扰；功能锻炼应动静结合，循序渐进，不应过分强调“坚强内固定、尽早负重活动”。

The causes of failure (non union,delayed union and malunion)of 51 cases of femoral shaft fracturaes after operation were analysed and the results showed:no adding essential external fixation,improper function training,contracture of knee joint and operation trauma also were principal factors of impairing healing,excepting improper internal fixation, no bone grafting for comminuted fracture and early weight bearing. It is considered that the key to healing the fracture is to maintain the stabilization of fracture in the early stage and prevent it from any stress interference;function training should be carried on correctly and gradually according to the stabilization and healing of fracture.