Abstract:

Objective　To compare the difference in effect of two methods g for treatment of large free bone block associated with femoral shaft fractures.    Methods     66 cases of femoral shaft fractures with large free bone block treated by open reduction and internal fixation were selected.According to different methods for large free bone block,they were divided into control group(35 cases,treated without drilling and without bone grafting) and test group(35 cases,treated with drilling and cancellous bone grafting liking rice transplant in the holes and surrounding).The two groups were compared in terms of operation time,operative bleeding,healing time of fracture,morbidity of complications and functionary recovery of the adjacent joints(HSS’s criterion) at the last follow-up.    Results    The two groups were not significantly different in clinical data (P>0.05).The operation bleeding (847.58±147.53 ml) and operative time (138.43±12.10 min) in the control group were superior to those in the test group（752.18±143.78 ml and 115.27±11.31 min, respectively）, but the healing time of fracture（4.79±1.00 month）, the morbidity of delayed healing(1/35), nonunion (0) and broken of internal fixation (0)，as well as the functionary recovery in the test group were superior to those in the control group (9.49±2.59 month，11/35，8/35，4/35 and 15/13/7/0, respectively), the differences were statistically significant (P<0.05).　Conclusion　As for free bone block associated with femoral shaft fractures, simple reduction and fixation has unsatisfied result,but drilling and cancellous bone grafting can promote healing of creeping substitution and improve mechanical property in the fracture ends, the result is superior to that in the former.

Key words: Femoral shaft fracture, Free bone block, Drilling, Bone graft