Introduction: Pseudarthrosis (PSA) of the diaphysis of long bones still remains a current problem, despite improvements in the treatment of these fractures. Our study aims to study the epidemiological and therapeutic ...Introduction: Pseudarthrosis (PSA) of the diaphysis of long bones still remains a current problem, despite improvements in the treatment of these fractures. Our study aims to study the epidemiological and therapeutic aspects of PSA of the diaphysis of long bones. Method: This retrospective work concerns 30 cases of non-union of the diaphysis of long bones treated in the orthopedic and trauma surgery department at Donka National Hospital, during a period of 18 months from January 1, 2019 to June 30, 2020. Results: We recruited 30 patients, 80% of whom were male, with an average age of 39.9 years. Public road accidents (AVP) represented the main cause of fractures of the diaphysis of long bones 87%, they were open in 25 cases or 83%. The fractures were located in the middle 1/3 of the diaphysis of the long bones in 50% of cases. Treatment of initial fractures was traditional in 21 cases, orthopedic in 2 cases and surgical in 7 cases. It was aseptic nonunion in 28 cases (93%) and septic nonunion in 2 cases. They were hypertrophic in 7 cases, slightly hypertrophic in 5 cases, oligotrophic in 11 cases, atrophic in 6 cases and with bone defect in 1 case. The treatment was based on osteosynthesis including 16 cases of screwed “PV” plate: 7 cases of centromedullary “ECM” nailing, 2 cases of external fixator, 1 case of broaching and 4 cases of Plastering. The results according to ASAMI criteria on an anatomical level were excellent in 19 cases, good in 3 cases and poor in 3 cases, with a union rate of 76%. And 5 patients undergoing consolidation. Conclusion: Based on the literature data and the experience of our department, the true treatment of PSA requires correct management of the initial fracture without forgetting the interest in preventing AVP which appears to be an element essential, making it possible to reduce the incidence of fractures of the diaphysis.展开更多
目的比较短节段骨水泥强化椎弓根螺钉与长节段普通椎弓根螺钉固定治疗老年胸腰椎爆裂骨折的临床效果。方法将80例老年胸腰椎爆裂骨折患者根据固定方式不同分为A组(40例,采用短节段骨水泥强化椎弓根螺钉固定治疗)和B组(40例,采用长节段...目的比较短节段骨水泥强化椎弓根螺钉与长节段普通椎弓根螺钉固定治疗老年胸腰椎爆裂骨折的临床效果。方法将80例老年胸腰椎爆裂骨折患者根据固定方式不同分为A组(40例,采用短节段骨水泥强化椎弓根螺钉固定治疗)和B组(40例,采用长节段普通椎弓根螺钉固定治疗)。记录两组手术情况、伤椎前缘高度丢失率、伤椎Cobb角、疼痛VAS评分及并发症发生情况。结果患者均获得随访,时间10~35个月。手术时间、切口长度、术中出血量A组均短(少)于B组(P<0.01)。疼痛VAS评分:术后4 d B组低于A组(P<0.01);末次随访两组比较差异无统计学意义(P>0.05)。伤椎前缘高度丢失率、伤椎Cobb角:两组术后、末次随访均较术前改善(P<0.05);两组末次随访与术后比较均有所丢失,但A组比较差异无统计学意义(P>0.05),而B组比较差异有统计学意义(P<0.05);两组术后比较差异均无统计学意义(P>0.05);末次随访A组均优于B组(P<0.05)。并发症发生率A组低于B组(P<0.05)。结论与长节段普通椎弓根螺钉相比,后路短节段骨水泥强化椎弓根螺钉固定治疗老年胸腰椎爆裂骨折具有手术切口小、术中出血少、手术时间短、术后椎体高度维持较好、并发症少等优点,但需注意骨水泥渗漏风险。展开更多
文摘Introduction: Pseudarthrosis (PSA) of the diaphysis of long bones still remains a current problem, despite improvements in the treatment of these fractures. Our study aims to study the epidemiological and therapeutic aspects of PSA of the diaphysis of long bones. Method: This retrospective work concerns 30 cases of non-union of the diaphysis of long bones treated in the orthopedic and trauma surgery department at Donka National Hospital, during a period of 18 months from January 1, 2019 to June 30, 2020. Results: We recruited 30 patients, 80% of whom were male, with an average age of 39.9 years. Public road accidents (AVP) represented the main cause of fractures of the diaphysis of long bones 87%, they were open in 25 cases or 83%. The fractures were located in the middle 1/3 of the diaphysis of the long bones in 50% of cases. Treatment of initial fractures was traditional in 21 cases, orthopedic in 2 cases and surgical in 7 cases. It was aseptic nonunion in 28 cases (93%) and septic nonunion in 2 cases. They were hypertrophic in 7 cases, slightly hypertrophic in 5 cases, oligotrophic in 11 cases, atrophic in 6 cases and with bone defect in 1 case. The treatment was based on osteosynthesis including 16 cases of screwed “PV” plate: 7 cases of centromedullary “ECM” nailing, 2 cases of external fixator, 1 case of broaching and 4 cases of Plastering. The results according to ASAMI criteria on an anatomical level were excellent in 19 cases, good in 3 cases and poor in 3 cases, with a union rate of 76%. And 5 patients undergoing consolidation. Conclusion: Based on the literature data and the experience of our department, the true treatment of PSA requires correct management of the initial fracture without forgetting the interest in preventing AVP which appears to be an element essential, making it possible to reduce the incidence of fractures of the diaphysis.
文摘目的比较短节段骨水泥强化椎弓根螺钉与长节段普通椎弓根螺钉固定治疗老年胸腰椎爆裂骨折的临床效果。方法将80例老年胸腰椎爆裂骨折患者根据固定方式不同分为A组(40例,采用短节段骨水泥强化椎弓根螺钉固定治疗)和B组(40例,采用长节段普通椎弓根螺钉固定治疗)。记录两组手术情况、伤椎前缘高度丢失率、伤椎Cobb角、疼痛VAS评分及并发症发生情况。结果患者均获得随访,时间10~35个月。手术时间、切口长度、术中出血量A组均短(少)于B组(P<0.01)。疼痛VAS评分:术后4 d B组低于A组(P<0.01);末次随访两组比较差异无统计学意义(P>0.05)。伤椎前缘高度丢失率、伤椎Cobb角:两组术后、末次随访均较术前改善(P<0.05);两组末次随访与术后比较均有所丢失,但A组比较差异无统计学意义(P>0.05),而B组比较差异有统计学意义(P<0.05);两组术后比较差异均无统计学意义(P>0.05);末次随访A组均优于B组(P<0.05)。并发症发生率A组低于B组(P<0.05)。结论与长节段普通椎弓根螺钉相比,后路短节段骨水泥强化椎弓根螺钉固定治疗老年胸腰椎爆裂骨折具有手术切口小、术中出血少、手术时间短、术后椎体高度维持较好、并发症少等优点,但需注意骨水泥渗漏风险。
