交锁髓内钉治疗股骨干骨折不愈合的原因分析及治疗

Cause analysis and treatment of interlocking intramedullary nail in the treatment fornonunion of femoral shaft fracture

目的探讨交锁髓内钉治疗股骨干骨折不愈合的原因及相应的治疗。方法总结10来年交锁髓内钉治疗股骨干骨折316例，其中骨折不愈合24例，通过锁定加压钢板（LcP）重新内固定后完全愈合。结果所有24例不愈合的患者将髓内钉取出，重新使用锁定加压钢板（LCP）内固定后得到完全愈合，1例需植骨。结论交锁髓内钉术后发生骨不愈合的原因很多，骨不愈合后使用锁定加压钢板重新内固定，固定牢固，断端充分加压，血运破坏少，促进骨折的愈合。

Objective To investigate the cause and its corresponding treatment of the interlocking intramedullary nail in curing nonunion of femoral shaft fracture. Methods In the past 10 years, 316 cases of interlocking intramedullary nail treating femoral shaft fractures were summarized, including 24 cases of nonunion, but, through the locking compression plate （LCP） with internal fixation, the cases completed healing at last. Results The intramedullary nails in all the 24 cases of nonunion were removed, and then used LCP for internal fixation complete healing, with only 1 patient requiring bone grafting. Conclusions There are many reasons causing postoperative bone nonunion after interlocking intramedullary nail operation, but after internal fixation using LCP again, fracture fixation, fracture broken end fully pressurized, and less destruction of blood supply, it can promote the healing of fracture.