内固定术后骨不连的微创治疗

Minimally Invasive Therapy on Bone Nonunion After Internal Fixation Operation

目的探讨内固定术后骨不连的微创植骨治疗效果。方法 2005-09/2012-12江西省人民医院骨二科收治17例内固定术后骨不连病人,使用自制5 mm窄囗微型骨铲、各种金属导管及扩容器、3.1 mm囗径微型环锯、研磨钵式电动粉粹机,在硬膜外阻滞式臂丛阻滞式局麻加周围神经阻滞麻醉下,作0.5-1 cm微切口进行微创植骨手术。结果 17例中,9例1月后摄片后出现断端毛玻璃样影像改变,3月后出现骨拆愈合征像,6例在术后6月后摄片出现骨拆愈合征像,1例在术后3月内固定断裂,再次手术治愈,1例经随访1年后仍无愈合征像,作血管蒂骨瓣移植愈合。治愈率88.23%。结论该院自制中空骨铲等器械行微创治疗效果较好,同时无明显不良反应发生。

Objective To observe the curative effect of minimally invasive bone grafting therapy on bone nonunion after internal fixation operation. Methods During Sept.,2005,to Dec. 2012,17 patients after operation of internal fixation operation in The Second Dept. of Orthopaedics,Jiangxi Provincial People＇s Hospital were recruited. The home-made 5 mm narrow bone spade,various kinds of metal conduits,3. 1 mm mini-type trepan and pot-like power-driven grinder were all employed for the operation. Under condition of epidural block type of brachial plexus block type local anesthesia and combined with peripheral nerve block anesthesia,0. 5-1 cm incision was made and minimally invasive bone grafting operation was conducted. Results Of the 17 cases,9 cases showed ground glass changes at the broken ends after X-ray test after one month and showed signs of fracture healing after three months; 6 cases showed signs of fracture healing after 6 months; one case exhibited fixed fracture in three months and was conducted re-operation,which showed no healing signs after one year and was treated with vascular pedicle bone graft and healed up at last. Conclusion With home-made hollowed bone spade and other instruments in this hospital,the minimally invasive operation is of good effect and free of obvious adverse reactions.