摘要
股骨干骨折不愈合的治疗方法众多,但临床疗效报道不一。更换髓内钉一直被认为是治疗股骨干骨折髓内钉术后骨折不愈合的金标准,极大提高了骨折不愈合治疗成功率,骨科医师至今仍首选此种治疗方法。但近期研究表明,髓内钉治疗股骨干骨折不愈合的失败率越来越高,保留原髓内钉加接骨板及自体骨移植被认为是治疗股骨干骨折不愈合的最有效方法之一。目前的药物治疗研究集中于甲状旁腺激素(1-34),又称特立帕肽,其主要用于治疗绝经后妇女的骨质疏松症,最新研究证实其在加速骨折愈合方面有很好的疗效。目前关于股骨干骨折不愈合的众多治疗方法缺乏循征医学等级支持。本文旨在对目前治疗股骨干骨折髓内钉术后骨折不愈合的相关国内外文献进行详细阐述及评价,为临床决策提供理论基础。
There are many treatment methods for the nonunion of femoral shaft fracture, but clinical efficacy reported was varied. Exchanging intramedullary nailing has been regarded as the golden standard in treating the nonunion of femoral shaft fracture. However, in recent years, some studies suggest that the failure rate of this method has become higher and higher. Retaining nail in combination with plates and autogenous bone grafting is becoming one of the most effective ways so far. Drug therapy focuses on parathyroid hormone（1-34）, also known as teriparatide. Teriparatide is originally used in treating postmenopausal osteoporosis. In recent years, it has achieved good curative effect in accelerating fracture union.Though there are many treatments of nonunion of femoral shaft fracture, they are in lack of evidence-based medical support.The current study aims to systematically review the literatures of treating nonunion of femoral shaft fracture after intramedullary nailing, and also provide theoretical basis for clinical practice.
作者
马显志
韩生寿
马骏
王凯
MA Xianzhi;HAN Shengshou;MA Jun;WANG Kai(Trauma Orthopedics Department, Qinghai Provincial People＇s Hospital, Xining 810000, China)
出处
《中华骨与关节外科杂志》
2018年第5期390-394,400,共6页
Chinese Journal of Bone and Joint Surgery
关键词
股骨骨折
骨折
不愈合
Femoral Fractures
Fractures
Ununited
