Ilizarov外固定“手风琴技术”治疗成人股骨骨不连Ilizarov frame fixation “accordion technique” for adult aseptic femoral nonunion
郭保逢;赵巍;徐执扬;吴鸿飞;陈蕾;秦泗河;
摘要(Abstract):
[目的]探讨Ilizarov外固定"手风琴技术"治疗成人股骨无菌性骨不连的临床疗效。[方法] 2012年7月~2017年1月,采用Ilizarov环形外固定缓慢牵伸-加压的"手风琴技术"治疗成人股骨无菌性骨不连11例。其中男7例,女4例,年龄24~47岁,平均(37.10±7.60)岁。患肢短缩>2.5 cm者术中结合股骨近端闭合截骨加装骨延长组件,备术后肢体延长。采用Paley骨不连评价标准进行评价。[结果] 11例患者获得随访,随访时间24~49个月,平均(27.47±6.70)个月。所有骨不连均临床骨性愈合,愈合时间6.00~24.70个月,平均(10.20±9.42)个月。采用Paley骨不连评价标准,优5例、良5例、可1例,优良率90.91%(10/11)。末次随访>7°局部畸形2例(7°、10°矢状位畸形),不影响功能,未作特殊处理。1例术后肢体短缩3.1cm。针道感染发生率72.73%(8/11),通过换药及更换固定针等控制,10°以上膝关节活动丢失3例,未发生再骨折、深部感染和血管神经损伤等并发症。[结论] Ilizarov外固定"手风琴技术"依据张力-应力法则,避免了植骨,规律牵伸-再加压治疗成人股骨无菌性骨不连疗效可靠。
关键词(KeyWords): Ilizarov方法;手风琴技术;股骨干骨折;无菌性骨不连
基金项目(Foundation):
作者(Author): 郭保逢;赵巍;徐执扬;吴鸿飞;陈蕾;秦泗河;
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参考文献(References):
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