可膨胀式自锁髓内钉治疗股骨干骨折不愈合12例

Expandable Self-locking Intramedullary Nailing for Non-union of Femoral Shaft:12 Cases Report

目的探讨可膨胀式自锁髓内钉治疗股骨干骨折不愈合患者的临床疗效。方法2005年4月至2008年4月在我院采用可膨胀式自锁髓内钉治疗12例股骨干骨折不愈合患者,其中肥大性不愈合7例,萎缩性不愈合5例。术中取出原有的固定物,去除骨折端硬化骨,钻通髓腔,顺行插入可膨胀式自锁髓内钉,5例萎缩性不愈合患者均植入自体髂骨松质骨。结果经过14个月的随访,12例股骨干骨折不愈合患者中11例获得了愈合,治愈率达91.7%。平均愈合时间为22.1周,没有出现感染、内固定断裂、神经血管损伤、旋转畸形及明显的短缩畸形等并发症。结论可膨胀式自锁髓内钉治疗股骨干骨折不愈合治愈率高,并发症少,是值得推荐的一种治疗方法。

Objective To explore the clinical efficacy of expandable intramedullary nailing in treating femoral shaft non-union. Methods Twelve patients suffering from hypertrophic or atrophic femoral shaft fracture non-union were enrolled in the study, Patients were treated with removal of pre existing hardware,decortication of non-union fragments, reduction and fixation with expandable intramedullary nailing （FixionTM ,Disc-O Tech Israel）. Results The fourteen months follow-up showed 91.7^（11/12）of patients attaining bony union. The average time to union was 22.1 weeks. No infection, neurovascular injury, fat embolism, break of internal fixation, rotational malalignment or obvious shortening were observed. Coneluslon The expandable intramedullary nailing is an alternative treatment of hypertrophic or atrophic femoral shaft fracture non-union with its excellent clinical efficacy and low complication incidence.