基础医学与临床 ›› 2012, Vol. 32 ›› Issue (5): 574-576.

• 研究论文 • 上一篇    下一篇

交锁髓内钉固定股骨干骨折术后骨不连原因分析

张志平1,张忠民2,金大地2   

  1. 1. 南昌大学第三附属医院
    2. 南方医科大学第三附属医院
  • 收稿日期:2011-12-29 修回日期:2012-03-27 出版日期:2012-05-05 发布日期:2012-04-16
  • 通讯作者: 金大地 E-mail:dadijin@163.com

Causes analysis of postoperative nonunion of femoral shaft fracture treated with intramedullary interlocking nail

  • Received:2011-12-29 Revised:2012-03-27 Online:2012-05-05 Published:2012-04-16

摘要: 目的 探讨股骨干骨折应用交锁髓内钉固定术骨不连的原因,并提出防治措施。 方法 对南昌大学第三附属医院2009年-2010年34例采用交锁髓内钉治疗股骨干骨折患者进行回顾性分析,其中对6例骨延迟愈合及3例骨不连者采取骨折端动力化,对1例骨不连者行取钉、更换内固定并植骨。 结果 骨延迟愈合6例骨延迟愈合及4例骨不连者,经过上述治疗,随访10个月以上,骨折愈合良好。 结论 静力交锁髓内钉固定的股骨骨折愈合主要通过膜内骨化,术中应避免损伤骨膜,适时采取骨折端动力化,通过软骨内骨化,减少术后骨不连。

关键词: 股骨骨折, 骨不连, 膜内骨化, 软骨内骨化, 交锁髓内针

Abstract: Objective To investigate the causes of postoperative complications of femoral shaft fracture treated with intramedullary interlocking nails Methods A total of 34 patients with femoral shaft fractures admitted to our hospital from 2009 to 2010 were retrospectively studied. They were all treated with intramedullary interlocking nails. The locking nails were removed from 6 patients with delayed union and 3 patients with nonunion to dynamise the fracture. For 1 patient with bone nonunion, the intramedullary interlocking nails were removed, and a larger one and bone grafts were applied. Results Followed up for more than 10 months, the fractures of 6 patients with delayed union and 4 patients with nonunion were completely healed. Conclusions The femoral shaft fracture healing treated with intramedullary interlocking nails depend mainly on intramembranous ossification so that periosteum invasion should be avoided during operations. Dynamisation of the fracture in time can reduce bone nonunion through endochondral ossification.

Key words: Femoral fractures, Nonunion, Intramembranous ossification, Endochondral ossification, Intramedullary interlocking nails

中图分类号: