- 期刊
DCP Fixation and Autogenous Bone Graft to Treat Nonunion of Femoral Shaft Fracture
使用動態壓迫性鋼板及自體骨移植治療股骨幹骨折未癒合
摘要
背景：股骨幹骨折是一種常見的下肢創傷，外科手術使用閉鎖式復式加交錯式骨髓內釘固定通常有不錯的結果且未癒合並不常見，然而仍有一些病人發生骨折未癒合的情形，需要更進一步的治療來達到癒合。本篇報告的目的在評估使用動態壓迫性鋼板固定加上自體骨移植來治療八個使用骨髓內鋼釘固定股骨幹骨折後未癒合之臨床效果。 方法：過去四年內來在本院有八例接受使用動態壓迫性鋼板固定加上自體骨移值來治療股骨幹骨折骨髓內釘固定後未癒合之病例。我們評估治療的臨床結果，並且提出一種使用K-鋼針鑽孔的修正技術來改善螺絲植入。 結果：八個病例中有七個病例達到密實之癒合且無併發症，一個病例在鋼板固定後發生骨髓內釘斷裂的情形。 結論：加強性的鋼板固定可以提高立即的力學穩定度，特別能抵抗扭轉應力，並且在手術時間及值入固定器費用上和其他治療股骨未癒合的方法相比是相當的。總之，此種方法是可行而有希望的，並有不錯的預後。而且，藉由K-鋼針預鑽孔的技術可以幫助螺絲鎖入，避免術中併發症的發生。
並列摘要
Background: Femoral shaft fracture is a relatively common injury of lower limbs, and surgery using close reduction with interlocking nail fixation usually produces good results with infrequent nonunion. However, some patients do develop fracture nonunion and need further surgical intervention to achieve union. The purpose of this report was to present the clinical results of dynamic compression plate (DCP) fixation with autogenous bone graft which was used to treat eight ununited femoral shaft fractures initially managed by intramedullary (IM) interlocking nailing. Methods: We treated eight cases of un united femoral shaft fracture with interlocking nail and later with dynamic compression plate fixation and autogenous bone graft supplementation at the China Medical College Hospital during the past 4 years. The clinical results were evaluated and a drilling technique with Kirschner wire (K-wire) for screw insertion was developed and is presented here. Results: Seven out of eight fractures united without complications. There was one case in which the nail broke after DCP fixation. Conclusions: Supplemental plate fixation promotes immediate mechanical stability, especially in terms of resisting torsion stress. Also, the cost of the implant and time consumed for this operation are comparable to other treatments of femoral nonunions. In summary, supplemental plate fixation is a practical and promising method with a good prognosis. Furthermore, the K-wire pre-drilled technique facilitates screw insertion and prevents intraoperative complications.
延伸閱讀
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