摘要
作者总结１２年来收治的骨折畸形愈合２０例，骨不连接２５例。对骨折畸形愈合恢复原长度及原结构后重新固定，对疏松型骨不连接采用髓内植自身１／３腓骨，髓外植自身髂骨。对硬化者切除硬化骨，肢体短缩者，骨折断端叠瓦式重叠植自身髂骨。本组病例，长骨干以梯形系列自动加压钢板固定。接近关节部的骨折采用Ｌ—梯形系列自动加压钢板固定，不做外固定。平均随访时间６年４个月，骨折全部愈合，功能恢复优良率达９８％。作者对骨不连接的病理和分型作了初步探讨，提出骨不连接的形成原因主要为医源性因素，因对骨折固定的基本要领掌握不够，特别是因内固定物选用不当或不按内固定的技术原则要求操作而造成的骨不连接。作者认为不能过份强调解剖复位，应以简单且有效的方法治疗骨折，不宜造成过大的损伤。
AbstractThe authors have reviewed the treatment of 20 cas-es of malunion and 25 cases of nonunion followlng limbfractures encountered in the last 12 vears.For the casesof malunion the original structure and shape of the hanewas at frist restored and fixatiOn was done again;ex-tramedullary and intramedullary auto bone grafts pro-cured from one-third of the fibula were perfotmed for thecases of osteoporotic type of nonunion, Resection reconstruction was done in cases of sclerotic nonunion.Lengthening of the shortened limb was performed usingoverlaping old coin shaped grafts taken from the ilium.The fracture of long bone shaft were fixed with TCP.The fracture near the joint was fixed with L TCP,Theaverage time of follow-up period was 6 years and 4months;the excellent rate of joint functiOnal recoverywas 98%.The author concluded that,the pathologyand nonunion formation were mainly cau sed by iatro-genic factors.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1995年第11期745-747,共3页
Chinese Journal of Orthopaedics
