摘要
目的分析肱骨干骨折内固定术后发生骨不连的原因,探讨预防对策。方法肱骨干骨折内固定术后发生骨不连10例,取出内固定物后改用可靠内固定加自体骨移植7例,外固定支架加压固定3例。结果平均随访18(5～24)个月,10例均达到骨性愈合,其中改用可靠内固定加自体骨移植者术后平均愈合时间为15(12～24)个月,改用外固定支架者为11(5～18)个月。结论发生肱骨干骨不连的主要原因是手术指征过宽、内固定器材选择不当、手术操作失误及术中过分破坏骨折端血运;而严格掌握手术适应证,注意保护断端周围血运,选择合适的内固定器材,并酌情结合可靠的外固定,可减少和避免骨不连的发生。
Objective To explore the causes and precautions of nonunion after internal fixation of humeral shaft fracture. Methods Ten patients of humeral shaft fracture suffered bone nonunion after internal fixation. All the original internal fixators were dislodged, with 7 changed to the reliable internal fixation and autogenous bone graft, and 3 used the external clamp stands. Results During 18 months （5 average -24） follow-up, all patients got synostosis. The bone union time was 15 months （ mean 12 - 24） and 11 months （ mean 5 - 18 ） respectively in reliable internal fixation and autogenous bone transplantation cases and external clamp stands cases. Conclusions The major causes of humeral shaft fracture nonunion are too wider operation indications, unsuitable internal fixators, and mal-manipulations such as excessive destroy of the blood supplies of the fracture ends. The bone nonunion of humeral shaft fracture may be controlled by strict operation indications, protection of the bloed supplies of fracture ends, suitable internal fixators,with firm external fixations pro re nata.
出处
《中国现代手术学杂志》
2007年第2期121-122,共2页
Chinese Journal of Modern Operative Surgery
关键词
肱骨骨折
骨折固定术
内
骨折愈合
humeral fracture
fracture fixation, internal
fracture healing
