股骨干骨折不愈合的原因分析及相关治疗Analysis of the causes of nonunion of femoral shaft fracture and related treatment.pdfVIP

提 要 目的：探讨股骨干骨折术后不愈合的影响因素和治疗方法。 方法：本研究病例来自山东中医药大学附属医院骨科病房自 2009 年 7 月至 2011 年 7 月收治股骨干骨折术后不愈合者 23 例，进行回顾性分析，总结股骨干骨折不愈 合的因素并根据患者不愈合类型及内固定方式进行个体化治疗，治疗方式采用更换内 固定物加自体髂骨植骨术,，合并感染的另给予冲洗引流术。二次手术后的治疗效果 根据“Illizarov 方法应用与研究学会”对骨不愈合及功能恢复的评价方法进行评定。 结果：所有 23 例患者 22 例均一次性治愈，达到骨性愈合，完全骨性愈合时间 6～ 8 个月，平均 6.8 个月。 结论：医源性因素(骨折复位不良、骨缺损、内固定材料选择不当、感染、未给 予植骨)和自身因素(骨折类型、过早负重、活动量过大) 以及应力因素是股骨干骨折不 愈合的三个主要原因，二次手术更换可靠内固定加自体髂骨植骨术，合并感染者给予 冲洗引流术疗效肯定。 关键词 股骨干骨折不愈合；个体化治疗 ；临床研究 Femoral shaft nonunion cause analysis and related treatment Speciality: Orthopedics of chinese medicine Author: Lu Liaodong Tutor: Prof. Zhang Junzhong Abstract Objective: To investigate the influencing factors and treatment of femoral shaft fractures do not heal after . Methods: In this study, cases from the orthopedic ward of Shandong Traditional Chinese Medicine University Hospital since July 2009 to July 2011 were femoral shaft fractures do not heal after surgery , 23 patients , were retrospectively analyzed the summary of the femoral shaft nonunion factors according to the patients and non-healing type of internal fixation for individualized treatment , treatment, replacement of internal fixation and autogenous iliac bone graft , another co-infection to give a flush drainage . Assessment of therapeutic effect evaluation method Illizarov Methods and Research Society on bone healing and functional recovery after the second surgery . Results: All 23 patients, 22 cases were one-time cure to achieve bony union , complete bone healing time of six to eight months , with an average of 6.8 months . Conclusion: Iatrogenic fa