扩髓髓内钉联合交叉韧带重建治疗股骨干骨折不愈合的临床研究

doi:10.13418/j.issn.1001-165x.2016.05.020

中国临床解剖学杂志 ›› 2016, Vol. 34 ›› Issue (5): 577-580.doi: 10.13418/j.issn.1001-165x.2016.05.020

扩髓髓内钉联合交叉韧带重建治疗股骨干骨折不愈合的临床研究

高怡加¹，　黄枫¹，　董航¹，　曾志奎²

1. 广州中医药大学第一附属医院骨科, 广州 510405; 2. 广州中医药大学第一临床医学院, 广州 510405

收稿日期:2016-04-05 出版日期:2016-09-25 发布日期:2016-10-14
作者简介:高怡加（1979-），男，广东汕头人，硕士，主治医师，专业方向:中医骨伤科学，创伤骨科，运动损伤，Tel：13798167268, E-mail：gaoyijia99@163.com
基金资助:
广东省第二批名中医师承项目

The clinical study of reamed intramedullary nail and cruciate ligament reconstruction used in the treatment of femoral shaft nonunion

GAO Yi-jia¹, HUANG Feng¹, DONG Hang¹, ZENG Zhi-kui²

1.Department of Orthopedics, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, China; 2. the First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China

Received:2016-04-05 Online:2016-09-25 Published:2016-10-14

摘要/Abstract

摘要：

目的　观察扩髓髓内钉联合交叉韧带重建治疗膝关节不稳型（合并交叉韧带损伤）股骨干骨折不愈合的临床疗效。方法　对10例合并交叉韧带损伤的股骨干骨折不愈合病例的临床研究，探讨分析膝关节稳定性对股骨干骨折愈合的影响，采用“原内固定取出+扩髓髓内钉重新固定股骨干+膝关节交叉韧带重建”的方法，治疗膝关节不稳型股骨干骨折不愈合。结果　10例患者均得到随访，股骨干骨折愈合率100%，Tohner-Wrnch标准评定优，膝关节功能 Lysholm评分优良率100% 。结论　膝关节不稳是股骨干骨折不愈合的一个重要因素；对股骨干骨折的治疗必须考虑是否合并膝关节不稳；“原内固定取出+扩髓髓内钉重新固定股骨干+膝关节交叉韧带重建”的治疗方法对合并交叉韧带损伤的股骨干骨折不愈合的临床疗效确切。

关键词: 骨折不愈合, 交叉韧带断裂, 膝关节不稳, 扩髓髓内钉, 交叉韧带重建

Abstract:

Objective　To observe effect of "reamed intramedullary nail and ligament reconstruction" to treat knee instability (combined with cruciate ligament injury) femoral shaft nonunion.　Methods　10 cases with femur bone nonunion combined with cruciate ligament injury were treated. The effect of stability of the knee to the femoral shaft fracture healing was analyzed. The femoral shaft nonunion caused by knee instability was treated with "the original implant removal + reamed intramedullary nailing of femoral shaft reseat + cruciate ligament reconstruction ".　Results　Ten patients were followed up with the healing rate being 100%. Tohner-Wrnch standard assessment was excellent, and Lysholm knee function score excellent rate was 100%.　Conclusion　Knee instability is an important factor of femoral shaft fracture nonunion; the treatment of femoral shaft fractures must consider whether knee instability exists.” Removal of original implant, fixation with reamed intramedullary nail and cruciate ligament reconstruction “is a reliable method for treatment of the femoral shaft nonunion combined with a cruciate ligament injury.

Key words: Bone nonunion, Cruciate ligament rupture, Knee instability, Reamed intramedullary nail, Cruciate ligament reconstruction

高怡加,黄枫,董航,曾志奎. 扩髓髓内钉联合交叉韧带重建治疗股骨干骨折不愈合的临床研究[J]. 中国临床解剖学杂志, 2016, 34(5): 577-580.

GAO Yi-jia, HUANG Feng, DONG Hang, ZENG Zhi-kui. The clinical study of reamed intramedullary nail and cruciate ligament reconstruction used in the treatment of femoral shaft nonunion[J]. Chinese Journal Of Clinical Anatomy, 2016, 34(5): 577-580.

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扩髓髓内钉联合交叉韧带重建治疗股骨干骨折不愈合的临床研究

The clinical study of reamed intramedullary nail and cruciate ligament reconstruction used in the treatment of femoral shaft nonunion

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