Application and research progress of double plate internal fixation combined with autogenous iliac bone graft for femur nonunion
10.3760/cma.j.cn121113-20200521-00342
- VernacularTitle:双钢板内固定联合自体髂骨植骨在股骨骨不连中的应用现状及研究进展
- Author:
Haobo YE
1
;
Liang SUN
;
Hanzhong XUE
;
Zhong LI
;
Ding TIAN
;
Na YANG
;
Kun ZHANG
Author Information
1. 西安医学院 710068
- From:
Chinese Journal of Orthopaedics
2020;40(16):1118-1125
- CountryChina
- Language:Chinese
-
Abstract:
Nonunion of femur is a common complication after intramedullary nail operation of femoral fracture, with an incidence of 1% to 12.5%. At present, the treatment of femoral nonunion is mainly divided into surgical treatment and non-operative treatment, and surgical treatment is the first choice. The gold standard for surgical treatment of femoral nonunion is replacement of intramedullary nail, but for non-isthmus femoral nonunion, larger diameter intramedullary nail could not solve the problem of rotation and angular displacement of the broken end of nonunion. For malnourished nonunion, atrophic nonunion and bone nonunion with large bone defect, the replacement of intramedullary nail and autogenous bone graft are not enough to eliminate the gap between the broken ends and increase the contact area between the broken ends. It cannot provide a good biological environment for the broken ends. Because the replacement of intramedullary nail does not expose the broken ends of bone nonunion, and the corresponding tissue cannot be taken for bacteriological culture, so it is difficult to judge whether the broken end sare complicated with infection. The double plate technique is to find the site of bone nonunion under direct vision, and two plates are placed with different angles. This paper reviews the literature related to the treatment of femoral nonunion with double plate technique published at home and abroad in the past 10 years, and concludes that double plate fixation combined with autogenous iliac bone graft provides a three-dimensional fixation model for the healing of nonunion. It has the characteristics of strong stability and plays an active role in improving the biological behavior and mechanical stability of the fracture ends. The operation is beneficial to the flexion and extension of the knee joint, with the characteristics of high healing rate, low complication rate, effective pain relief and so on.
