肱骨干骨不连的不同外科修复

Different surgical treatment for nonunion of humerus

目的 探索肱骨骨不连的外科治疗效果。 方法 对不同肱骨骨不连分别采用三种外科术式予以处理 :(1)无明显骨缺损之骨不连 ,采用骨形成蛋白复合物植入方式 ,促进骨愈合 ;(2 )对骨不连有良好内固定 ,而骨折端有 3～ 5 mm骨缺损时 ,采用吻合血管的髂骨骨膜皮质骨瓣移植方法予以修复 ;(3)对肱骨粉碎性骨折造成的多平面骨不连 ,则采用吻合血管游离腓骨移植术式予以重建。 结果 对于肱骨骨不连 ,采用 BMP/ FS植入治疗 12例 ,吻合血管髂骨骨膜薄皮质骨瓣植入修复 8例 ,吻合血管腓骨移植治疗 9例。经术后 3～ 2 4个月随访 ,均获得良好愈合。 结论 以上三种术式采用 ,对肱骨骨不连的外科手术指征、手术方式提供了有益经验。

Objective To study the therapeutic effectiveness of several surgical treatment for nonunion of humerus Method Twenty nine cases of humerus nonunion were treated in 3 different ways Twelve cases of humerus nonunion without bone defect were rapaired with implantation of composite of bone morphogenetic protein and fibrin sealant (BMP/FS) to promote bone healing Eight cases with favorable fixation and 3～5 mm of bone defect were repaired by transplantation of illiac cortex periosteum flap with vascular anastomosis 9 cases with multiple level nonuion of humerus shaft from comminuted fracture were reconstructed fibular transplantation with vascular anastomosis Results Followed up for 3 to 24 months,all of the 29 cases had favorable bone healing and limb function Conclusions The application of the 3 operation methods would have some helpful experience for the treatment of humerus nonunion