论文部分内容阅读
目的探讨单臂外支架结合自体骨植骨治疗儿童股骨骨折后骨不连的临床疗效。方法对该院2006年1月至2013年12月收治36例股骨骨不连采用残骨端病灶清除、髓腔再通、单臂外支架固定及自体骨植骨治疗患儿的临床资料进行回顾性分析。结果 36例患儿术后均获得随访,根据改良的ASAMI评定标准进行评价,优21例,良9例,可5例,差1例;骨生长良好,均达到骨性愈,其中1例患儿术后6个月后断骨端无明显骨痂形成,经过自体骨髓移植治疗及外支架调整后,30个月后到达骨性愈合;1例患儿骨愈合拆除外支架后自行行走致同侧股骨再次发生骨折,予以手术外支架固定和自体骨髓移植,36个月后达到骨性愈合,膝关节及髋关节功能恢复良好。结论单臂外支架治疗儿童股骨骨不连具有操作相对简单、利于创面处理和修复、患儿易耐受、固定牢固等优点,可有效促进膝、踝关节功能的恢复;自体骨可缩短骨折的愈合时间,减少自身免疫排斥反应的发生。因此,单臂外支架联合自体骨植骨是治疗儿童股骨不连的有效治疗方法。
Objective To investigate the clinical effect of single arm external stent combined with autologous bone graft in the treatment of nonunion of femur fracture in children. Methods From January 2006 to December 2013, 36 cases of femoral nonunion were treated with removal of residual bone, recanalization of medullary cavity, fixation of single arm and autologous bone graft in children Sexual analysis. Results Thirty-six children were followed up and evaluated according to the modified ASAMI criteria. The results were excellent in 21 cases, good in 9 cases, fair in 5 cases and poor in 1 case. The bone growth was good, At 6 months after operation, there was no obvious callus formation at the end of the broken bone. After autologous bone marrow transplantation and external stent adjustment, bone healing was achieved 30 months later. One case of bone healing followed the same procedure after removal of the external scaffold Fractures occurred again on the side of the femur, to be outside the stent and autologous bone marrow transplantation, bone healing after 36 months, knee and hip function recovered well. CONCLUSION: The single arm external scaffold has the advantages of relatively simple operation, good wound treatment and repair, easily tolerated children and firm fixation, which can effectively promote the recovery of knee and ankle joint function. Autologous bone can shorten the fracture Healing time, reduce the incidence of autoimmune rejection. Therefore, the one-armed external scaffold with autologous bone graft is an effective treatment for children with femoral nonunion.