扩髓髓内钉联合交叉韧带重建治疗股骨干骨折不愈合的临床研究

The clinical study of reamed intramedullary nail and cruciate ligament reconstruction used in the treatment of femoral shaft nonunion

目的观察扩髓髓内钉联合交叉韧带重建治疗膝关节不稳型(合并交叉韧带损伤)股骨干骨折不愈合的临床疗效。方法对10例合并交叉韧带损伤的股骨干骨折不愈合病例的临床研究,探讨分析膝关节稳定性对股骨干骨折愈合的影响,采用"原内固定取出+扩髓髓内钉重新固定股骨干+膝关节交叉韧带重建"的方法,治疗膝关节不稳型股骨干骨折不愈合。结果 10例患者均得到随访,股骨干骨折愈合率100%,Tohner-Wrnch标准评定优,膝关节功能Lysholm评分优良率100%。结论膝关节不稳是股骨干骨折不愈合的一个重要因素;对股骨干骨折的治疗必须考虑是否合并膝关节不稳;"原内固定取出+扩髓髓内钉重新固定股骨干+膝关节交叉韧带重建"的治疗方法对合并交叉韧带损伤的股骨干骨折不愈合的临床疗效确切。

Objective To observe effect of＂reamed intramedullary nail and ligament reconstruction＂to treat knee instability （combined with cruciate ligament injury） femoral shaft nonunion. Methods 10 cases with femur bone nonunion combined with cruciate ligament injury were treated. The effect of stability of the knee to the femoral shaft fracture healing was analyzed. The femoral shaft nonunion caused by knee instability was treated with ＂the original implant removal ＋ reamed intramedullary nailing of femoral shaft reseat ＋ cruciate ligament reconstruction ＂. Results Ten patients were followed up with the healing rate being 100%. Tohner-Wrnch standard assessment was excellent, and Lysholm knee function score excellent rate was 100%. Conclusion Knee instability is an important factor of femoral shaft fracture nonunion;the treatment of femoral shaft fractures must consider whether knee instability exists.”Removal of original implant, fixation with reamed intramedullary nail and cruciate ligament reconstruction“is a reliable method for treatment of the femoral shaft nonunion combined with a cruciate ligament injury.