PDF(Pubmed)
Abstract：
The purpose of this study is to evaluate the efficacy of plate augmentation and hybrid bone grafting for treating atrophic nonunion of the femur with original intramedullary nail retained in situ.In this study, 36 patients with atrophic nonunion of the femur who underwent surgery using the technique of plate augmentation and a hybrid bone grafting while retaining the original intramedullary nail in situ in Xi\'an Honghui Hospital from January 2019 to December 2021 were enrolled. 28 patients who met the inclusion and exclusion criteria were ultimately included in the study. These 28 patients, consisting of 20 males and 8 females with a mean age of 38 years, were evaluated based on factors such as operation time, intraoperative blood loss, the average hospitalization days. Additionally, the results and function of these patients were evaluated by union time, Wu\'s scores of limb function and incidence of serious complications.All 28 patients achieved bone union at the 12 month follow-up, with an average follow-up time of 14.6 ± 4.2 months.The average operation time was 68.3 ± 11.2 min, and the average intraoperative blood loss was 140 ± 22.6 ml. Patients were hospitalized for an average of 5.8 ± 1.1 days. Full clinical and radiological bone union was achieved on average at 5.1 ± 1.9 months. The mean value of Wu\'s scores at the 12 month follow-up was significantly higher than before the operation. Limb function was excellent in 27 patients and good in one patient at the 12 month follow-up. However, five patients experienced the lower limb vein thrombosis, including one deep vein thrombosis and four lower limb intermuscular vein thromboses. One patient had a superficial infections of the surgical incision site, while three patients reported pain and numbness where their iliac bone graft was extracted at the 12 month follow-up. The technique of plate augmentation and hybrid bone grafting, combined with retaining the original intramedullary nail in situ has been shown to be a safe, effective, simply and standardizable practice for treating atrophic femoral nonunion with an intact original IMN fixation.
摘要：
这项研究的目的是评估钢板增强和混合骨移植在原位保留原始髓内钉治疗股骨萎缩性骨不连的疗效。在这项研究中,纳入2019年1月至2021年12月在西安红会医院接受了36例股骨萎缩性骨不连患者，这些患者在保留原髓内钉原位的同时，使用钢板强化和混合植骨技术进行了手术。28名符合纳入和排除标准的患者最终纳入研究。这28个病人,由20名男性和8名女性组成，平均年龄为38岁，根据手术时间等因素进行评估，术中失血,平均住院天数。此外,通过愈合时间评估这些患者的结果和功能，Wu\s肢体功能评分及严重并发症发生率。所有28例患者在12个月随访时都实现了骨愈合，平均随访14.6±4.2个月。平均手术时间为68.3±11.2min,术中出血量平均为140±22.6ml。患者平均住院5.8±1.1天。平均在5.1±1.9个月时实现了完全的临床和放射学骨愈合。随访12个月时Wu’s评分均值明显高于术前。在12个月的随访中，27例患者的肢体功能良好，1例患者的肢体功能良好。然而,5例患者下肢静脉血栓形成,包括1例深静脉血栓形成和4例下肢肌间静脉血栓形成。一名患者手术切口部位浅表感染，而3例患者报告疼痛和麻木，他们的髂骨移植在12个月的随访中被拔除。钢板强化和混合植骨技术，结合保留原来的髓内钉在原位已被证明是安全的，有效,用完整的原始IMN固定治疗萎缩性股骨骨不连的简单而标准化的做法。
