锁定加压钢板疗四肢长管状骨骨不连的临床应用.pdfVIP

提 要 目的：观察锁定加压钢板治疗四肢长管状骨骨不连的临床疗效。方法：2004 年 12 月～2007 年 12 月锁定加压钢板治疗四肢骨干骨折不愈合患者 20 例，其中男性 15 例， 女性5例，患者年龄18～75岁，平均年龄40.6岁。股骨干不愈合10例，胫骨不愈合6 例，肱骨干不愈合 4例；受伤原因:车祸伤16例，摔伤4例；钢板螺钉断裂不愈合8例， 钢板螺钉松动9例，外固定支架固定骨不愈合1例，髓内钉骨折不愈合2例；肥大型不 愈合 9 例，萎缩型不愈合 11 例。采用二次手术取出原内固定物，重新行锁定加压钢板 内固定，同时在不愈合部位行丰富的自体髂骨或人工骨植骨。术后进行影像学观察和疗 效评定。结果：本组20例病人均获得随访，随访时间6～20个月，骨折全部骨性愈合， 愈合时间为 3～8 个月，平均 4.6 个月，无钢板断裂及螺钉松动、无感染、延迟愈合或 再次骨不连等并发症。关节功能优良率为90.0％。结论：锁定加压钢板能够为骨折端提 供早期的稳定性，减少局部血运的破坏，与植骨相结合是治疗骨干骨折不愈合的一种有 效方法。 关键词 骨折；骨不连；锁定加压钢板；骨移植 Clinical Application of locking compression plate in the treatment of nonunion of long bone Speciality: Traditional Chinese orthopaedics and traumatology Author: Cui Yi-dong Tutor: Prof. Li Jin-song Abstract Objective ：To observe the clinical effect of locking compression plate (LCP) for the treatment of nonunion of long bone.Methods:20 cases of long bone nonunion from Nove.2004 to Nove.2007 were treated with locking compression plate ，including 15 male and 5 female.The ages of the subjects were 18～75 years (average 40.6 age).20 cases of nonunion include 10 cases of femoral nonunion,6 cases of tibia nonunion,4 cases of humerus nonunion ， including 9 cases of hyperplasia and 11 atrophia ．All cases were treated by removing previous internal fixation instruments and locking compression plate was used to remain bone fracture. At the meantime ，the opulent autogenerous cancellous or artificial bone was grafted at the location of nonunion ．The outeome of the treatment was assessed by X-ray .Results ：All the patients were available for folow-up after the second operation from 6 to 20 months.They were healed after the reoperation.The healing time varied from 3 to 8 months,averaged 4.6 months.Infection,refracture and breaking