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1、提要目的：探讨股骨干骨折术后不愈合的影响因素和治疗方法。方法：本研究病例来自山东中医药大学附属医院骨科病房自2009年7月至2011年7月收治股骨干骨折术后不愈合者23例，进行回顾性分析，总结股骨干骨折不愈合的因素并根据患者不愈合类型及内固定方式进行个体化治疗，治疗方式采用更换内固定物加自体髂骨植骨术,，合并感染的另给予冲洗引流术。二次手术后的治疗效果根据“Illizarov方法应用与研究学会”对骨不愈合及功能恢复的评价方法进行评定。结果：所有23例患者22例均一次性治愈，达到骨性愈合，完全骨性愈合时间6～8个月，平均6.8个月。结论：医源性因素
2、(骨折复位不良、骨缺损、内固定材料选择不当、感染、未给予植骨)和自身因素(骨折类型、过早负重、活动量过大)以及应力因素是股骨干骨折不愈合的三个主要原因，二次手术更换可靠内固定加自体髂骨植骨术，合并感染者给予冲洗引流术疗效肯定。关键词股骨干骨折不愈合；个体化治疗；临床研究FemoralshaftnonunioncauseanalysisandrelatedtreatmentSpeciality:OrthopedicsofchinesemedicineAuthor:LuLiaodongTutor:Prof.ZhangJunzhongAbstractO
3、bjective:Toinvestigatetheinfluencingfactorsandtreatmentoffemoralshaftfracturesdonothealafter.Methods:Inthisstudy,casesfromtheorthopedicwardofShandongTraditionalChineseMedicineUniversityHospitalsinceJuly2009toJuly2011werefemoralshaftfracturesdonothealaftersurgery,23patients,we
4、reretrospectivelyanalyzedthesummaryofthefemoralshaftnonunionfactorsaccordingtothepatientsandnon-healingtypeofinternalfixationforindividualizedtreatment,treatment,replacementofinternalfixationandautogenousiliacbonegraft,anotherco-infectiontogiveaflushdrainage.Assessmentofthera
5、peuticeffectevaluationmethodIllizarovMethodsandResearchSocietyonbonehealingandfunctionalrecoveryafterthesecondsurgery.Results:All23patients,22caseswereone-timecuretoachievebonyunion,completebonehealingtimeofsixtoeightmonths,withanaverageof6.8months.Conclusion:Iatrogenicfactor
6、s(poorfractures,bonedefects,improperfixationmaterialsselection,infection,didnotgiveabonegraft),andtheirownfactors(typeoffracture,andearlyweight-bearingactivitiesexcessive),andstressfactorsoffemoralshaftfracturesthreemainreasonsfornothealing,thesecondsurgerytoreplacethereliabl
7、efixationandautogenousiliacbonegraft,co-infectionweregivendrainagetechniqueiseffective.Keywordsfemoralshaftnonunion;individualtherapy;clinicalresearch目录引言..........................................................................................................................
8、.....1临床研究..........................................................
