桥接组合式内固定系统治疗长骨骨折术后骨不连

Application of bridge combined fixation system in nonunion of limbs long bone fracture after surgery

目的探讨桥接组合式内固定系统治疗四肢长骨骨折术后骨不连的疗效。方法对25例股骨、胫骨、肱骨骨不连的患者采用骨皮质剥离Phemister植骨,桥接组合式内固定系统固定治疗。结果 25例均获得随访,时间12~18个月。骨折全部愈合,时间6~11个月。无骨感染,未发生内固定松动、脱落、断棒、断钉以及关节僵硬情况。肢体功能采用Sanders标准评价疗效:优23例,良1例,可1例,优良率96%(24/25)。结论桥接组合式内固定系统集钢板、髓内钉、外固定架的优势为一体,可骨膜外放置,多方向置钉,三维固定,具有固定可靠、内固定失效少、临床疗效满意的优点,是四肢长骨骨折术后骨不连治疗的一种新选择。

Objective To investigate the application curative effect of bridge combined fixation system for treatment of nonunion of limbs long bone fracture after surgery. Methods The 25 cases of nonunion with femur, tibia and hu- merus were treated with cortical stripping Phemister bone grafting and bridging combined internal fixation system. Resuits All 25 cases were followed up for 12 - 18 months. All fractures of healing time was 6 - 11 months. No bone in- fection, internal fixation loose, fall off, broken rods, broken nails and joint stiffness occurred. Limb function was e- valuated by using Sanders standard, excellent in 23 cases, good in 1 case, fair in 1 case, excellent-good rate was 96% （24/25）. Conclusions The bridge combined fixation system is accorded.with the feature of fracture biome- chanieal fixation, and a blend of locking plate, interlocking intramedullary nail and external fixator, which reduce the breakage of vessels near fracture part, but also afford firm and dynamic fixation for fracture fragmen. So it is an effec- tive therapeutic approach for limbs long bone fractures.