交锁髓内钉结合结构性加压植骨治疗股骨干骨不连

Clinical effect of interlocking intramedullary nail combined with structural compression bone grafting for nonunion of femoral shaft: a new method of bone grafting

目的观察交锁髓内钉结合结构性加压植骨治疗股骨干骨不连的疗效。方法采用一种新型的植骨方法结合交锁髓内钉治疗12例股骨干骨折术后骨不连的患者(男性9例,女性3例,平均年龄43.6岁),观察其疗效。结果术后随访6~18月(平均11.2月),所有患者最终获得影像学上的骨性愈合,愈合率100%,愈合时间16~40周(平均25.6周)。无明显并发症发生。结论这种新型的植骨方式结合交锁髓骨钉技术是治疗股骨干骨不连的一种有效方法。

Objective To observe the clinical effect of interlocking intramedullary nail combined with bone grafting used for treatment of femoral nonunion. Methods In this study, we describe a novel approach of bone grafting harvest from the autogenous ilium. Twelve patients （nine men, three women, average age 43.6 years） with nonunion of femur were treated with interlocking intramedullary nail combined with structural compression bone grafting. Results After an average follow-up of 11.2 （6 - 18） months, all patients achieved radiographic evidence of solid union. The healing rate is 100%. All patients demonstrated radiographic evidence of bone healing with an average follow-up of 25.6 weeks （range 16 - 40weeks）. No failure occurred due to bent or broken nail, intramedullarynails or bone grafting. Conclusion Treatment of nonunion of femur with interlocking intramedullary nail combined with structural compression bone grafting is an effective option. The technique of bone grafting we described is an ideal method for femur nonunion.