交锁髓内钉治疗下肢长管状骨骨折不愈合及延迟愈合

Interlocking nail in treatment of delayed union and non-union of long bone fracture of the leg

目的分析导致下肢长管状骨骨折不愈合和延迟愈合的原因及治疗方法。方法对13例下肢长管状骨骨折不愈合及延迟愈合患者均采用交锁髓内钉治疗。闭合穿钉2例,切开复位内固定11例,术中同时植骨9例。所有病例术中均行静力型交锁,其中4例后期动力化。结果13例患者均达到骨性愈合,愈合时间12～23个月,平均14.5个月。结论扩髓型交锁髓内钉治疗下肢长管状骨骨折的不愈合及延迟愈合效果满意,治疗的关键在于扩髓、选择合适的髓内钉、必要时动力化锁定。

Objective To explore the causes and management of delayed un ion and non-union of long bone fracture of the leg. Methods 13 cases of delayed union and non-union of long bone fracture of the leg were treated with interlo cking intramedullary nails. 2 cases were given close implanting, and 11 cases we re managed with open reduction, of whom 9 were also grafted with autogenous bone . All patients were given early static interlocking, and 4 cases were given late dynamic interlocking. Results X-rays and follow-up showed that all patients h ealed up after an average of 14.5 months.Conclusions Interlocking intramedullary nails are a satisfactory method to treat delayed union and non-union of long b one fracture of the leg. The key points of the operation are reaming, selecting suitable nails and dynamic interlocking when necessary.