钢板固定联合自体髂骨植骨治疗股骨髓内钉失败骨不连的效果观察

Curative Effect of Plate Fixation Combined with Autologous Iliac Crest Graft on Nonunion after Femoral Nail Failure

目的观察钢板固定联合自体髂骨植骨治疗股骨髓内钉失败骨不连的临床效果。方法回顾性分析本院在2017年1月-2018年12月收治的股骨髓内钉失败术后骨不连患者20例,采取钢板联合自体髂骨植骨治疗的方法对骨折部位进行治疗,观察术后患者的X线片情况、骨折愈合时间以及疼痛评分和生活质量评分情况。结果 (1)X线片显示,术后患者骨折线模糊,有连续性骨痂通过骨折线,骨折部位局部无压痛或叩击痛;(2)术后骨折都在4-11个月内愈合,且骨折部位生长良好,未出现切口感染、下肢深静脉血栓等并发症;(3)术后患者疼痛评分低于术前,生活质量评分高于术前,差异具有统计学意义(P<0.05)。结论钢板固定联合自体髂骨植骨治疗股骨髓内钉失败骨不连临床疗效较好,安全可靠,值得在临床中推广和使用。

Objective To observe the clinical curative effect of plate fixation combined with autologous iliac crest graft(AICG) on nonunion after femoral nail failure. Methods A retrospective analysis was performed on 20 patients with nonunion after femoral nail failure who admitted to the hospital from January 2017 to December 2018. The fracture sites were treated with plate fixation combined with AICG. The postoperative X-ray films, fracture healing time, scores of pain and quality of life were observed. Results(1) X-ray films showed that fracture line was blurred after surgery. There were continuous osteotylus going through fracture line. There was no tenderness or percussion pain in fracture sites.(2) The fractures were all healed within 4-11 months after surgery. The growth of fracture sites was well. There were no complications such as incision infection or deep vein thrombosis of lower limbs.(3) After surgery, pain score was decreased, while quality of life score was increased(P<0.05). Conclusion The clinical curative effect of plate fixation combined with AICG is good on nonunion after femoral nail failure. It is safe and reliable.