目的:我们假设传统的髂三皮质骨移植(无血管化)在促进一定大小的不愈合缺损的骨愈合方面仍有合理的作用。这里,我们通过回顾性病例系列报告了临床/放射学结局.
方法:我们筛选了2008年至2018年在门诊就诊的74例上肢长骨明确不愈合患者。在这些患者中,对符合我们纳入/排除标准的25名患者进行了调查。
结果:平均年龄为51.92岁,桡骨有12、9、1和3个病灶,尺骨,锁骨,和肱骨,分别。主要固定的工具是24例和1例患者的钢板和髓内钉,分别。六名患者出现萎缩性骨不连。先前手术的平均时间为6.84个月。平均缺损骨大小分别为清创前和清创后1.81和3.50cm,分别。所有装置的锁定板都比前一个板更长,三名患者同时用螺钉固定移植物。修正手术后平均15.92周,所有患者都经历了工会。在最后的后续行动中,临床结果令人满意.根据病变,临床结果没有发现显著差异,非工会类型,从之前的手术开始,或者采集髂骨的长度。
结论:如果考虑了适当的适应症和一些技术方面,超过3厘米的非血管化髂骨移植仍然是治疗上肢骨干不愈合的合理选择。
方法:四级,回顾性病例系列。
We hypothesised that traditional iliac
tricortical bone grafts (no vascularised) still have a reasonable role in promoting satisfactory bony healing in non-union defects of certain sizes. Here, we report the clinical/radiological outcomes through a retrospective case series.
We screened 74 patients with definitive non-union in the long bones of the upper extremities who visited the outpatient department from 2008 to 2018. Among these patients, 25 who met our inclusion/exclusion criteria were investigated.
The mean age was 51.92 years, and there were 12, 9, 1, and 3 lesions of the radius, ulna, clavicle, and humerus, respectively. The tools for primary fixations were plate and intramedullary nails in 24 and 1 patients, respectively. Six patients presented with atrophic non-union. The mean period from a previous surgery was 6.84 months. The mean defective bone sizes were 1.81 and 3.50 cm pre-debridement and post-debridement, respectively. All devices had locking plates longer than the previous plate, and the graft was concurrently fixed by screws in three patients. At a mean of 15.92 weeks after the revision surgery, all patients experienced union. At the final follow-up, the clinical outcomes were satisfactory. No significant differences in clinical outcomes were found according to the lesion, type of non-union, period from the previous surgery, or harvest length of the iliac bone.
If the proper indications and some technical aspects are considered, a non-vascularised iliac bone graft longer than 3 cm could still be a reasonable option for treating diaphyseal non-union of the upper extremities.
Level IV, retrospective case series.