摘要
目的:探讨加压交锁髓内钉内固定加交锁髓内钉开口处取骨植骨治疗胫骨骨不连的临床疗效。方法:回顾性分析自2008年2月至2010年10月采用加压交锁髓内定内固定加髓内针开口处取骨植骨治疗18例胫骨骨干骨不连,男12例,女6例;年龄31～67岁,平均42岁。受伤至手术时间6～18个月,平均8个月。骨折不愈合11例,延迟愈合7例。术后根据HSS评分系统评价膝功能,采用Tenny和Wiss评分系统评估疗效。结果:术后随访12～36个月,平均18个月,患者切口愈合良好,无感染,无皮肤坏死。全部患者未见骨不愈合、感染、畸形及再骨折发生。骨性愈合时间4～8个月,平均6个月。患者术后1年膝关节功能HSS评分平均(89.97±3.21)分。术后根据Tenny和Wiss评分系统评估疗效,优16例,良2例。结论:采用加压交锁髓内钉内固定加交锁髓内钉开口处取骨植骨治疗胫骨骨折不愈合及延迟愈合,能提高骨折愈合率,避免髂骨取骨带来的并发症,减少患者医疗费用。
Objective：To explore the curative effect of intramedullary nailing pressure within a fixed period with a bone graft taken from the opening of intramedullary nailing on tibial fracture nonunion.Methods：From February 2008 to October 2010,18 patients with nonunion of tibial shaft were treated by pressurized intramedullary nail fixation and bone grafting taken from the opening of intramedullary nailing.They included 12 males and 6 females ranging in age from 31 to 67（mean 42） years.The time from injury to surgery was 6-18 months（mean 8 months）.There were 11 cases of nonunion and 7 cases of delayed union.After operation,the knee function was evaluated according to HSS scoring.The therapeutic effect was assessed by Tenny-Wiss scoring system.Results：All patients were followed up for 12-36（mean 18） months.The wound healed well without infection or skin necrosis.All patients had no nonunion,infection,deformity,and re-fracture.The bone healing time was from 4 to 8 months（mean 6 months）.The HHS score of knee function 1 year after surgery averaged（89.97±3.21）.The effect result of Tenny and Wiss scoring system was excellent in 16 cases and good in 2 cases.Conclusion：Open reduction by intramedullary nail fixed within a period with bone graft（from the opening of intramedullary nailing） for treatment of nonunion and delayed union of tibial fracture can improve the fracture healing rate,avoid complications from iliac bone grafting,and reduce medical expenses.
出处
《中国骨伤》
CAS
2012年第4期331-334,共4页
China Journal of Orthopaedics and Traumatology
关键词
胫骨骨折
骨折
不愈合
骨折固定术
髓内
骨移植
Tibial fractures
Fractures
ununited
Fracture fixation
intramedullary
Bone transplantation
