交锁髓内钉联合骨瓣、骨膜瓣治疗四肢骨不连及骨缺损

Treatonent of Nonunion and Bone Defect of Extremities with Vascularied Bone Flap or Periosteal Flap and Cross-medullary Nail

目的 探讨应用交锁髓内钉联合带血管的骨瓣、骨膜瓣治疗四肢骨不连、骨缺损的临床效果。方法 应用交锁髓内钉联合带血管的骨瓣、骨膜瓣移植治疗四肢骨不连、骨缺损 2 4例。全部患者得到随访 ,平均随访时间 1 6年。其中采用带血管腓骨移植 1 5例 ;带血管蒂腓骨转移 2例 ;带血管髂骨瓣 3例 ;带血管股骨内髁骨瓣移植 1例 ;带血管腓骨骨膜移植 4例 ;带血管胫骨骨膜瓣转移 1例。结果 2 4例患者全部临床愈合 ,未出现感染、髓内主钉及锁钉断裂等并发症 ,关节功能良好。结论 应用交锁髓内钉联合带血管的骨瓣、骨膜瓣移植治疗四肢骨不连、骨缺损是一种确实有效的方法。

Objective To investigate the clinical effect of the treatment of extremitys nonunion and bone defect with vascularied bone flap or periosteal flap and cross medullary nail.Methods Twenty four patients with extremitys nonunion or bone defect operatively treated were followed up.The average period of followed up was 1 6 years.The type of vascularied bone flap and periosteal flap,15 cases vascularied fibular flap transplantation;2 cases vascularied fibular flap transposition,3 cases vascularied ilium flap transplatation,1 case vascularied medial condyle flap of femur transplantation;4 cases vascularied fibular periosteal transplantation;1 case vascularied tibial periosteal flap transposition.Results All 24 cases clinical heal,the average period of heal time was 6 5 months.No complication,including infection,nail breakage was found.All the patients junction of joint is good.Conclusion It is a effect method to treat nonunion and bone defect with vascularied bone flap and periosteal flap with cross medullary nail.