交鎖髓內釘動力化治療股骨干骨折不愈合_《中國修復重建外科雜志》

作者：

程堅 ¹ , 符培亮 ² , 陶波 ¹

1 余姚市人民醫院骨一科（浙江余姚，315400 ）;;
2 上海市長征醫院骨科;

關鍵詞：

髓內釘股骨干骨折動力化固定

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目的總結交鎖髓內釘動力化固定對骨折愈合的影響，分析動力化固定后可達到正常愈合的類型。方法回顧性分析2005年6月－2010年8月30例初始行靜力鎖定后再行動力化固定患者臨床資料。男25例，女5例；年齡18～60歲，平均34歲。股骨干骨折26例，轉子下骨折4例。均為閉合損傷。根據AO分型：A1型2例，A2型2例，A3型1例，B1型5例，B2型6例，B3型2例，C1型8例，C2型4例。根據骨折或不愈合端的力學穩定性和生物活性分型：穩定/增生型8例、穩定/萎縮型5例、不穩定/增生型9例、不穩定/萎縮型8例。于初次靜力釘術后6～18周，平均14周后行髓內釘動力化固定。結果術后患者切口均Ⅰ期愈合。30例均獲隨訪，隨訪時間6～18個月，平均12個月。24例骨折于動力化固定后3～6個月完全愈合，4例于7～11個月延遲愈合，2例不愈合。3例不穩定/萎縮型患者出現明顯股骨短縮，1例不穩定/萎縮型患者出現旋轉移位。結論髓內釘動力化治療股骨干骨折不愈合療效確切，但不穩定/萎縮型患者行動力化固定術后并發癥較多。

引用本文： 程堅,符培亮,陶波. 交鎖髓內釘動力化治療股骨干骨折不愈合. 中國修復重建外科雜志, 2013, 27(1): 125-126. doi: 復制

1.	Kempf I, Grosse A, Beck G. Closed locked intramedullary nailing: its application to comminuted fractures of the femur. J Bone Joint Surg (Am), 1985, 67(5): 709-720.
2.	Egger EL, Gottsauner-Wolf F, Palmer J, et al. Effects of axial dynamization on bone healing. J Trauma, 1993, 34(2): 185-192.
3.	Larsson S, Kim W, Caja VL, et al. Effect of early axial dynamization on tibial bone healing. Clin Orthop Relat Res, 2001, (388): 240-251.
4.	Park J, Kim SG, Yoon HK, et al. The treatment of nonisthmal femoral shaft nonunions with im nail exchange versus augmentation plating. J Orthop Trauma, 2010, 24(2): 89-94.
5.	Papakostidis C, Psyllakis I, Vardakas D, et al. Femoral-shaft fractures and nonunions treated with intramedullary nails: the role of dynamisation. Injury, 2011, 42(11): 1353-1361.
6.	Basumallick MN, Bandopadhyay A. Effect of dynamization in open interlocking nailing of femoral fractures. A prospective randomized comparative study of 50 cases with a 2-year follow-up. Acta Orthop Belg, 2002, 68(1): 42-48.
7.	Tigani D, Fravisini M, Stagni C, et al. Interlocking nail for femoral shaft fractures: is dynamization always necessary? Int Orthop, 2005, 29(2): 101-104.
8.	Richmond J, Colleran K, Borens O, et al. Nonunions of the distal tibia treated by reamed intramedullary nailing. J Orthop Trauma, 2004, 18(9): 603-610.
9.	潘垚, 安智全, 曾炳芳. 交鎖髓內釘早期動力化治療脛骨干骨折. 中華創傷骨科雜志, 2006, 8(8): 734-736.
10.	Fadero PE, Alabi S, Adebule GT, et al. Locked intramedullary nailing for the treatment of femoral shaft fractures: experience and result in 19 cases. Niger J Med, 2008, 17(2): 168-172.

1. Kempf I, Grosse A, Beck G. Closed locked intramedullary nailing: its application to comminuted fractures of the femur. J Bone Joint Surg (Am), 1985, 67(5): 709-720.
2. Egger EL, Gottsauner-Wolf F, Palmer J, et al. Effects of axial dynamization on bone healing. J Trauma, 1993, 34(2): 185-192.
3. Larsson S, Kim W, Caja VL, et al. Effect of early axial dynamization on tibial bone healing. Clin Orthop Relat Res, 2001, (388): 240-251.
4. Park J, Kim SG, Yoon HK, et al. The treatment of nonisthmal femoral shaft nonunions with im nail exchange versus augmentation plating. J Orthop Trauma, 2010, 24(2): 89-94.
5. Papakostidis C, Psyllakis I, Vardakas D, et al. Femoral-shaft fractures and nonunions treated with intramedullary nails: the role of dynamisation. Injury, 2011, 42(11): 1353-1361.
6. Basumallick MN, Bandopadhyay A. Effect of dynamization in open interlocking nailing of femoral fractures. A prospective randomized comparative study of 50 cases with a 2-year follow-up. Acta Orthop Belg, 2002, 68(1): 42-48.
7. Tigani D, Fravisini M, Stagni C, et al. Interlocking nail for femoral shaft fractures: is dynamization always necessary? Int Orthop, 2005, 29(2): 101-104.
8. Richmond J, Colleran K, Borens O, et al. Nonunions of the distal tibia treated by reamed intramedullary nailing. J Orthop Trauma, 2004, 18(9): 603-610.
9. 潘垚, 安智全, 曾炳芳. 交鎖髓內釘早期動力化治療脛骨干骨折. 中華創傷骨科雜志, 2006, 8(8): 734-736.
10. Fadero PE, Alabi S, Adebule GT, et al. Locked intramedullary nailing for the treatment of femoral shaft fractures: experience and result in 19 cases. Niger J Med, 2008, 17(2): 168-172.

《中國修復重建外科雜志》

交鎖髓內釘動力化治療股骨干骨折不愈合

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《中國修復重建外科雜志》

交鎖髓內釘動力化治療股骨干骨折不愈合

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