辅助钢板治疗股骨干骨折髓内钉内固定术后骨不愈合的临床研究

The Study on Augmentative Plating With a Nail Left in Situ for Aseptic Femoral Shaft Nonunion After Intramedullary Nailing

目的分析辅助钢板治疗股骨干骨折髓内钉内固定术后骨不愈合的临床疗效。方法回顾性分析自2012年1月—2016年6月我院收治的股骨干骨折髓内钉内固定术后骨不愈合病例12例,均行保留原髓内钉+辅助钢板内固定+自体骨植骨治疗。主要观测指标为手术时间、术中出血量、影像学愈合时间等。结果 12例患者的平均手术时间为(80.1±10.7)min,平均术中出血量(150±30)ml;所有患者术中及术后均无输血,均获得骨性愈合,平均术后骨愈合时间为(5.6±2.1)个月。结论保留原髓内钉+辅助钢板内固定+自体骨植骨术治疗股骨干骨折髓内钉内固定术后不愈合,其对患者的创伤小,操作简便,易于掌握。

Objective The purpose of this study is to analyze the clinical efficacy of augmentative plating with a nail left in situ for femoral shaft nonunion after intramedullary nailing. Methods From January 2012 to June 2016, 12 cases of femoral shaft nonunions after intramedullary nailing were treated. 12 patients were treated with augmentative plating combined with autogenous bone grafting. The main outcome measure included of operating time, intra-operative blood loss and time to radiographic union. ResultsThe average operating time was（80.1±10.7） min in all 12 patients. The average intra-operative blood loss was（150±30） ml and no patient needed to transfuse blood. All 12 cases obtained osseous union and the average osseous union time was（5.6±2.1） months. Conclusion Augmentative plating leaving the nail in situ with autogenous bone grafting may be a reliable and easy method for extensive application for femoral shaft nonunion.