Abstract:

 Objective To investigate the effects of bone callus excision and bone grafting in the treatment of nonunion of the tibia in the late stage of bone removal. Method Retrospective analysis of in 22 patients with tibial bone defect treated with bone transport technique between Jan 2012 to Jun 2016 was performed. All 22 cases failed to heal in the late stage of bone removal were subjected to surgical procedure including bone callus incision, removal of the soft tissue of the bone end pressure, cleaning sclerosing osteomyelitis, bone grafting. Results Twenty-two patients were followed up for five to 18 months（average 8 months）. Of them, 18 cases were healed after bone grafting. Wound infection occurred in two cases and finally healed by conservation treatment. Bone graft resorption was experienced in one case, who received the second bone grafting and healed. One case underwent internal fixation and the second bone graft due to a fixed loosening and fracture. According to the evaluation of Paley and other nonunion healing score, the Results were excellent in 18 cases, good in one cases, middle in 1 cases, poor in 1 cases, and the excellent and good rate was 86.36%. Conclusion In patients with nonunion of tibial bone in the late stage of bone removal, bone callus incision combined with graft callus in the bro-ken end was the effective surgical method.

Key words: bone removal, bone nonunion, cutting callus, bone grafting

摘要：

目的 探讨削骨痂植骨治疗胫骨骨搬运后期骨不连的疗效和经验。方法 回顾性分析2012年1月至2016年6月应用骨搬运技术治疗的胫骨骨缺损患者，选取在骨搬运后期对合端未能顺利愈合的患者22例，行切开手术，清除骨端软组织卡压、清理硬化骨，削取对合端或延长段骨痂回植于胫骨对合端，使对合端最终骨性愈合。结果 22例患者术后获5～18个月（平均8个月）随访，其中18例削痂植骨术后顺利愈合，2例术后发生伤口感染，经清抗感染治疗，最终愈合；1例患者植骨吸收，经历再次植骨后愈合；1例患者途中外固定松动，导致骨折，更改为内固定+植骨，最终愈合；其余21例根据Paley等骨不连愈合评分标准评定结果：优18例，良1例，中1例，差1例，优良率为86.36％。结论 胫骨骨搬运后期胫骨骨不连通过非手术方法不能愈合的患者，可尝试削取骨痂植骨的方治疗使对合端愈合。

关键词: 骨搬运, 植骨, 骨不连 , 削骨痂