Application of locked intramedullary nails in the treatment of complications after distraction osteogenesis.
Application of locked intramedullary nails in the treatment of complications after distraction osteogenesis.
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锁髓内钉在牵张成骨术后并发症治疗中的应用
DOI：
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发表时间：
2002
影响因子：
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通讯作者：
J. H. Chen
中科院分区：
文献类型：
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作者：
K. Lai;C. J. Lin;J. H. Chen
牵张成骨术已广泛应用于四肢长度不等或大量骨缺损的患者。然而，这种手术可能与身体和心理并发症的高发有关。在锁定髓内钉上伸缩胼胝体可缩短外固定时间。锁髓内钉在胼胝体术后并发症治疗中的应用鲜有报道。在1990年至1999年间，我们对27例牵张成骨术后并发症的患者进行了锁定髓内钉治疗。有17名男性和10名女性，平均年龄为33.2岁（16至66岁）。取下外固定架后平均3.4周（0 ~ 15周）入钉。同时进行自体骨移植和软组织重建分别为7例和2例。术后平均6.4个月（2 - 14），所有患者的骨痂或对接部位均出现实变。愈伤组织平均缩短0.7 cm（0 ~ 2.5）。2例患者在远端螺钉处感染，在拔出钉子后感染消失。在17例患者中，指甲在插入后平均26个月被拔除。锁髓内钉是治疗骨成熟患者牵张成骨后并发症的有效方法。应牢记感染的危险。
Distraction osteogenesis (callotasis) has been widely used in patients with limb-length inequality or massive bone defects. This procedure, however, may be associated with a high incidence of physical and psychosocial complications. Callotasis telescoping on a locked intramedullary nail has been used to shorten the period of external fixation. Little attention has been given to the use of locked intramedullary nails in the treatment of complications after callotasis. Between 1990 and 1999, we used locked intramedullary nailing in 27 patients for the treatment of complications after distraction osteogenesis. There were 17 men and ten women with a mean age of 33.2 years (16 to 66). The nail was inserted at a mean of 3.4 weeks (0 to 15) after removal of the external fixator. Simultaneous autogenous bone grafting and soft-tissue reconstruction were also undertaken in seven and two patients, respectively. There was consolidation of the callus or docking site in all patients at a mean of 6.4 months (2 to 14) after surgery. The mean shortening of the callus was 0.7 cm (0 to 2.5). Two patients had infection at the site of a distal screw which resolved after removal of the nail. In 17 patients the nail was removed at a mean of 26 months after its insertion. Locked intramedullary nails are useful in treating complications after distraction osteogenesis in skeletally mature patients. The risk of infection should be borne in mind.