双钢板内固定联合自体髂骨植骨治疗股骨干骨折术后骨不愈合效果观察

Observation on the effect of double-plate internal fixation combined with autogenous iliac bone graft in the treatment of nonunion after femoral shaft fracture

目的:探讨双钢板内固定联合自体髂骨植骨治疗股骨干骨折术后骨不愈合效果。方法:选取2018年2月~2020年10月收治的60例股骨干骨折术后骨不愈合患者分为A组和B组,A组给予双钢板内固定联合自体髂骨植骨治疗,B组给予髓内钉内固定治疗,比较两组患者手术及恢复指标,膝关节、髋关节活动度,临床疗效。结果:A组患者手术时间、术中出血量、术后引流量、愈合时间较B组患者显著降低(P<0.05),A组患者膝关节活动度(伸展角度、屈曲角度)、髋关节活动度(内收角度、外展角度)较B组患者显著改善(P<0.05),A组临床疗效优良率显著高于B组患者(P<0.05)。结论:双钢板内固定联合自体髂骨植骨治疗股骨干骨折术后骨不愈合可缩短手术时间,减少术中出血量,促进骨折的愈合,恢复膝关节和髋关节的功能,提高疗效,值得推广。

Objective:To investigate and analyze the effect of double-plate internal fixation combined with autogenous iliac bone grafting in the treatment of postoperative nonunion of femoral shaft fractures.Method:76 cases of postoperative nonunion of femoral shaft fractures admitted from February 2018 to October 2020 were selected and divided into groups A and B.Group A was treated with double plate internal fixation combined with autogenous iliac bone grafting,and group B was treated with intramedullary nail internal fixation.The operation and recovery indicators and conditions,joint mobility,VAS and ODI scores before and one month after surgery.of the two groups were compared,and the knee and hip functions were recovered.Results:The operation time,intraoperative blood loss,and postoperative drainage volume of group A patients were significantly lower than those of group B(P<0.05).The range of motion of the knee joint(extension angle,flexion angle)and the range of hip joint motion(adduction angle,abduction angle)in group A were significantly improved compared with those in group B(P<0.05).The excellent and good rate of clinical efficacy in group A was significantly higher than that in group B(P<0.05).Conclusion:Double-plate fixation combined with autogenous iliac bone grafting to treat nonunion of femoral shaft fractures after femoral shaft fractures can shorten the operation time,reduce intraoperative blood loss,promote fracture healing,and restore the function of knee and hip joints,which is worthy of promotion.