摘要
目的 对近 5年收治的 15例难治性股骨干骨折骨不连进行总结 ,探讨难治性股骨干骨折骨不连的成因及显微外科治疗方法。方法 分别采用带血管髂骨移植治疗 13例 ,带血管腓骨移植治疗 2例 ,其中使用外固定架治疗 6例 ,钢板固定 9例。结果 15例中均 7～ 15个月达到临床愈合 ,13例出现膝关节活动障碍 ,其中9例再次行膝关节松解术。结论 带血管的髂骨及腓骨移植作为植入骨 ,治疗难治性股骨干骨不连效果较好 ,既有一定强度 ,又能尽快恢复血运。术中无创操作、尽量少剥离骨膜、采用合理的内固定物及膝关节功能练习是此类手术成功的关键。
Objective To review 15 patients with nonunion of femoral shaft fracture encountered in the last 5 years and to explore the microsurgical methods of treatment.Methods All the cases had nonunion after operation in an average duration of 20.5 months.Of the 15 cases,13 were treated with vascular iliac bone graft,2 with vascular fibula bone graft,9 with different types of compression plates and bonegrafts,6 with aplication of the multifunctional external fixation apparatuses and bone grafts.Results Fifteen cases obtained clinical healing in 7～15 months.Function of the knee was limited in 13 cases,while 9 cases had secondary relaxation produre of the knee joint.Conclusions The vascular bone grafts in the treatment of the femoral shaft nonunion is a good method because of the intensity and instant recovery of the blood supply.Protection of the intact tissue duting the operation,selection of suitable internal fixation device ,stripping of the periosteoma(edema) little as possible is the key step to prevent femoral shaft nonunion.
出处
《潍坊医学院学报》
2004年第6期423-425,共3页
Acta Academiae Medicinae Weifang
关键词
骨折
股骨
骨不连
显微外科
手术
Fracture,Femoral shaft
Fracture nonunion
Microsurgery
