摘要
目的 分析前臂骨折手术后引起严重畸形与骨不连的发生因素及其治疗方法 ,提高再手术治疗的愈合率 ,减少病废。方法 对 37例前臂骨折患者再手术原因进行分析。再手术方法 :①严重畸形者截骨矫正、植骨。②缺损在 3cm以内者取自体髂骨嵌插性植入 ,植骨保证稳定性。缺损≥ 3cm≤ 5cm者采用髂骨植骨钢板螺钉内固定。 5cm以上缺损者采用吻合血管的游离腓骨移植。结果 第一次术后引起畸形与骨不连的主要原因 :内固定方法不当 16例 ,感染 10例 ,外固定时间过短 6例 ,再次外伤 5例。再手术后骨折愈合率91 9%。结论 前臂骨折术后骨不连应及早再手术 ,缺损处植骨 ,缺损大者吻合血管游离腓骨移植 。
Objective To analyze various factors of severe malunion and nonunion of forearm fracture and raise the healing rate after reoperation and reduce disability. Methods 37 cases with failure of forearm fractures that need reoperation were enrolled. The causes of failure were analysed. The reoperation methods included:① Severe malunion was corrected with osteotomy and bone graft. ② The bone defects less than 3 cm were treated with iliac graft. The defects more than 3 cm to less than 5 cm were treated with iliac graft and plating and those more than 5 cm were treated with the vascular fibular graft. Results The causes of malunion and nonunion were unsuitable treatment methods in 16 cases, infection in 10 cases, short duration of immobilization and reinjury in 5 cases. The healing rate of reoperation is 91.9%. Conclusion Reoperation should be performed as soon as possible for forearm fracture fixation facture. The bone defect should be filled with bone graft and the massive one should be treated with vascular fibular graft. The severe malunion should be corrected with osteotomy.
出处
《临床骨科杂志》
2004年第1期82-84,共3页
Journal of Clinical Orthopaedics
关键词
前臂骨折
骨折
不愈合
骨缺损
骨折固定术
再手术
forearm fractures
fracture, ununited
defect of bone
fracture fixation
reoperation
