在交换钉治疗股骨干不连接的过程中,植骨对骨结合的影响。

Northern clinics of Istanbul Pub Date : 2024-07-31 eCollection Date: 2024-01-01 DOI:10.14744/nci.2023.43410
Cumhur Deniz Davulcu, Sertac Saruhan, Emre Bilgin, Eyup Cagatay Zengin
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摘要

研究目的本研究旨在探讨骨移植对交换钉(EN)治疗股骨干非不连的骨结合的影响:本研究共纳入 26 名患者(16 名男性)。患者的平均年龄为(36.1±9.3)岁。8例患者采用了植骨术(植骨组),18例患者未采用植骨术(无植骨组)。对最初受伤时的病因、骨折类型、位置和骨折分类进行了评估。此外,还记录了复位类型(开放式或闭合式)和钢钉的锁定状态。还记录了非愈合类型。在骨移植组中,七名患者使用了髂骨自体移植,一名患者使用了合成骨移植。在 EN 之后,对每组患者的骨结合情况、骨结合持续时间以及钉子直径的增加情况进行了分析和比较:结果:植骨组和未植骨组的骨结合率分别为 100%和 94.4%。两组的平均愈合时间差异不大(分别为 22.5 个月和 16.5 个月)。植骨组的钉子直径平均增加了 1.88 毫米,未植骨组增加了 2.00 毫米(P>0.05):该研究表明,在治疗股骨干非不连时,无论是否进行植骨,使用直径更大的钉子都能达到较高的愈合率,而植骨对愈合率和愈合期没有显著影响。
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Effect of bone grafting on bone union in exchange nailing for the treatment of femoral shaft nonunions.

Objective: This study aims to investigate the effect of bone grafting on the bone union in exchange nailing (EN) for the treatment of femoral shaft nonunions.

Methods: A total of 26 patients (16 male) were included in this study. The mean age of the patients was 36.1±9.3. Bone grafts were used in 8 patients (bone graft group), and EN was performed without bone grafting (no bone graft group) in 18 patients. Etiology, fracture type, location, and classification of the fractures at the time of initial injury were evaluated. The reduction type (open or closed) and locking status of the nails were also noted. Nonunion types were recorded. In the bone grafting group, iliac bone autografts were used in seven patients and a synthetic bone graft was used in one patient. Following EN, the presence and duration of bone union, and the increase in the nails' diameter were analyzed for each group and compared.

Results: Union rates were 100% and 94.4% in bone grafting and no bone grafting groups, respectively. The mean union period was not significant between the groups (22.5 and 16.5 months, respectively). The mean increase in the nail diameter was 1.88 mm in the bone graft group and 2.00 mm in the no bone graft group (p>0.05).

Conclusion: This study demonstrated that high union rates can be achieved with EN by means of using larger diameter nails with or without bone grafting in the management of femoral shaft nonunions, and bone grafting had no significant effect on union rates and periods.

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