外固定架结合自体松质骨移植治疗难治性骨不连

Treatment of refractory bone nonunion with cancellous bone autograft plus external fixator

目的探讨骨断端有限修整后颗粒状骨移植治疗难治性骨不连的效果。方法2003年3月-2006年7月，对13例难治性骨不连患者采用骨断端有限修整后外固定架固定、自体颗粒状骨移植方法治疗。结果平均随访22．6个月（19～30个月），所有患者均获得骨愈合，并在随访终点前完全负重或恢复以前工作。外固定架固定时间平均为10．6个月（7～18个月）。8例患者发生间隙性或持续性针道感染，经过治疗后感染停止或缓解，拆除外固定架后无感染残留。结论骨断端有限修整后自体颗粒状骨移植是治疗难治性骨不连的有效方法。

Objective To investigate the curative effect of granulated cancellous hone autograft in treatment of refractory bone nonunion after limited contouring of hone ends. Methods Between 2003 and 2006, 13 patients with refractory bone nonunion were treated with external fixation and granulated cancellous bone autograft after limited contouring of bone ends. Results The mean follow-up period was 22.6 months （ 19-30 months）, which showed that all patients gained bone union and resumed complete weight loading or previous job at final follow-up. The mean fixation time of external fixators was 10.6 months （7-18 months）. The intermittent or persistent pin-track infection occurred in eight patients and relieved by pin-track care and oral or parenteral antibiotics, with no infection after removing external fixator. Conclusion The granulated cancellous bone autograft after limited contouring of bone ends is an effective method for treatment of refractory bone nonunion.