TREATMENT OF POSTOPERATIVE NONUNION OF FRACTURE OF LOWER LIMB WITH BONE GRAFTINGby intervertebral disc endoscope_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANG Jianlin , TAN Yue , YE Jun , HAN Fangmin.

No.1 Department of Orthopaedics, the Affiliated Hospital of Yan’an University, Yan’an Shaanxi, 716000, P.R.China.;

Corresponding author：

Keywords：

Intervertebral endoscope; Lower l imb fracture; Nonunion; Bone graft; Minimal invasive technique

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【Abstract】 Objective To explore the effectiveness of bone grafting by intervertebral disc endoscope for postoperative
nonunion of fracture of lower limb. Methods Between August 2004 and August 2008, 40 patients (23 males and 17 females) with postoperative nonunion of femoral and tibial fracture, aged 20-63 years (mean, 41.5 years) were treated. Nonunion of fracture occurred at 10-16 months after internal fixation. During the first operation, the internal fixation included interlocking intramedullary nail ing of femoral fracture in 12 cases and plate in 16 cases, and interlocking intramedullary nail ing of tibial fractures in 9 cases and plate in 3 cases. The X-ray films showed hypertrophic nonunion in 24 cases, common nonunion in 3 cases, and atrophic nonunion in 13 cases. Results The average operation time was 61 minutes (range, 40-80 minutes), and the blood loss was 80-130 mL (mean, 100 mL). The hospital ization time were 6-11 days (mean, 8.1 days). Incisions healed by first intention in all patients with no complication of infection or neurovascular injury. Forty patients were followed up 10-16 months (mean, 12.3 months). The X-ray films showed that all patients achieved healing of fracture after 4-10 months (mean, 6.8 months). No pain, disfunction, or internal fixation failure occurred. Conclusion Bone grafting by intervertebral disc endoscope is an effective method for treating postoperative nonunion of femoral and tibial fracture.

Citation： ZHANG Jianlin,TAN Yue,YE Jun,HAN Fangmin.. TREATMENT OF POSTOPERATIVE NONUNION OF FRACTURE OF LOWER LIMB WITH BONE GRAFTINGby intervertebral disc endoscope. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(2): 212-214. doi: Copy

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8.	陆维举, 李斌, 钱宏波, 等. 清创后Ⅰ期颗粒状自体松质骨移植治疗感染性骨不连. 中华医学杂志, 2010, 90(23): 1609-1611.
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10.	Khan SA, Shamshery P, Gupta V, et al. Locking compression plate in long standing clavicular nonunions with poor bone stock. J Trauma, 2008, 64(2): 439-441.
11.	Ring D, Kloen P, Kadzielski J, et al. Locking compression plates for osteoporotic nonunions of the diaphyseal humerus. Clin Orthop Relat Res, 2004, (425): 50-54.
12.	姚鹏浩, 谈帅, 何丽. 长骨骨折术后骨不连原因及外科治疗的探讨. 中国医学创新, 2010, 7(4): 180-181.
13.	陈健荣, 温建强, 卢国良. 带锁髓内钉加植骨治疗股骨干骨折骨不连. 内蒙古医学杂志, 2010, 42(6): 707-708.
14.	韦敏克, 梁斌, 尹东, 等. 胫骨骨折术后骨不连治疗方法的疗效比较. 中国矫形外科杂志, 2007, 15(12): 904-907.
15.	Hak DJ. The use of osteoconductive bone graft substitutes in orthopaedic trauma. J Am Acad Orthop Surg, 2007, 15(9): 525-536.
16.	Cavadas PC, Landin L. Treatment of recalcitrant distal tibial nonunion using the descending genicular corticoperiosteal free flap. J Trauma, 2008, 64(1): 144-150.
17.	Brinker MR, O’Connor DP, Crouch CC, et al. Ilizarov treatment of infected nonunions of the distal humerus after failure of internal fixation: an outcomes study. J Orthop Trauma, 2007, 21(3): 178-184.

1. 谷效斌. 胫骨骨折术后骨不连原因分析及治疗措施. 临床误诊误治, 2011, 24(6): 61-63.
2. 胥少汀, 葛宝丰, 徐印坎. 实用骨科学. 3版. 北京: 人民军医出版社, 2005: 877．.
3. 刘桂发, 王晖. 带锁髓内钉与动力加压钢板治疗股骨干骨折骨不连疗效观察. 吉林医学, 2011, 32(19): 3922-3923.
4. 潘桂华, 张金标. 椎间盘镜下植骨术治疗骨不连16例疗效观察. 山东医药, 2006, 46(3): 38.
5. 赵伟, 杨晓杰, 燕红伟. 自体髂骨移植治疗骨不连36例患者的围手术期护理. 中国医学创新, 2010, 7(18): 102-103.
6. 王巧珍, 林代利, 李虹, 等. 自体髂骨移植治疗骨不连的中医护理干预. 现代中西医结合杂志, 2011, 20(4): 499-500.
7. 王剑飞, 温应辉, 袁和森, 等. 自体髂骨移植+适当的内固定治疗难治性骨不连13例报告. 中外健康文摘, 2010, 7(23): 99.
8. 陆维举, 李斌, 钱宏波, 等. 清创后Ⅰ期颗粒状自体松质骨移植治疗感染性骨不连. 中华医学杂志, 2010, 90(23): 1609-1611.
9. Webb LX. Bone defect nonunion of the lower extremity. Tech Orthop, 2001, 16(4): 387-397.
10. Khan SA, Shamshery P, Gupta V, et al. Locking compression plate in long standing clavicular nonunions with poor bone stock. J Trauma, 2008, 64(2): 439-441.
11. Ring D, Kloen P, Kadzielski J, et al. Locking compression plates for osteoporotic nonunions of the diaphyseal humerus. Clin Orthop Relat Res, 2004, (425): 50-54.
12. 姚鹏浩, 谈帅, 何丽. 长骨骨折术后骨不连原因及外科治疗的探讨. 中国医学创新, 2010, 7(4): 180-181.
13. 陈健荣, 温建强, 卢国良. 带锁髓内钉加植骨治疗股骨干骨折骨不连. 内蒙古医学杂志, 2010, 42(6): 707-708.
14. 韦敏克, 梁斌, 尹东, 等. 胫骨骨折术后骨不连治疗方法的疗效比较. 中国矫形外科杂志, 2007, 15(12): 904-907.
15. Hak DJ. The use of osteoconductive bone graft substitutes in orthopaedic trauma. J Am Acad Orthop Surg, 2007, 15(9): 525-536.
16. Cavadas PC, Landin L. Treatment of recalcitrant distal tibial nonunion using the descending genicular corticoperiosteal free flap. J Trauma, 2008, 64(1): 144-150.
17. Brinker MR, O’Connor DP, Crouch CC, et al. Ilizarov treatment of infected nonunions of the distal humerus after failure of internal fixation: an outcomes study. J Orthop Trauma, 2007, 21(3): 178-184.

Chinese Journal of Reparative and Reconstructive Surgery

TREATMENT OF POSTOPERATIVE NONUNION OF FRACTURE OF LOWER LIMB WITH BONE GRAFTINGby intervertebral disc endoscope

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