Autologous lilac bone-grafting and bridging plate fixation in treatment of atrophic bone nonunion of the distal ulna with osseous defect in 21 cases
- VernacularTitle:自体髂骨嵌入式植骨和桥接钢板置入固定治疗尺骨远端缺损性萎缩性骨不连21例
- Author:
Yunfeng CHEN
;
Yimin CHAI
;
Bingfang ZENG
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2009;13(4):785-788
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Forceful fixation and enough blood supply in fracture site are the fundament for treating bone nonunion. OBJECTIVE:To investigate the outcome of autologous lilac bone-grafting and plate fixation in treatment of the ununited distal ulnar fracture with osseous defects. DESIGN,TIME AND SETTING:The own control study was performed at the Department of Orthopaedics,Sixth People's Hospital,Shanghai Jiao Tong University from August 2002 to May 2006. PARTICIPANTS:Of 21 cases of the ununited distal ulnar fracture with osseous defects,13 cases were induced by ulnar and radial fracture,and 8 cases were induced by ulnar fracture. There were 15 cases of open fracture and 6 cases of closed fracture of first onset. Bone defects were 1.5 cm-5.0 cm,averagely 3.1 cm. METHODS:Bone defects were filled with intercalary lilac grafts. Length and axial ray of ulna were controlled. Ulna was fixed utilizing 5-8 wells 1/3 tubular plate,reconstruction plate or locking compression plate. At least two screws were used at the distal end,and 3 or 4 screws were fixed in the proximal end,FoUow-up was conducted once per month to observe clinical appearances and radiograph in each patient. MAIN OUTCOME MEASURES:Fracture nonunion,dorsal extension and palmer flexion of wrist joint,pronation and supination of the forearm were measured. RESULTS:All 21 cases were followed up for a mean time of 14.7 months. All the patients obtained bony union,and a mean time of 4.6 months (ranged 3 to 7 months). The distal ulnar healed with < 10° of angular deformity in a coronal plane in one patient and with 15° of angulation in a sagittal plane in another one,while others (19 patients) obtained satisfactory alignment. The excellent and good rate was 90.5％. CONCLUSION:Intercalary bone-grafting with autologous lilac and secure fixation for treating the ununited distal ulnar fracture with osseous defects can reconstruct ulnar length,correct deformities,and obtain good bone healing and functional recovery.
