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首页> 外文期刊>Journal of orthopaedics and traumatology: official journal of the Italian Society of Orthopaedics and Traumatology >Ilizarov technique in management of nonunited fracture of both bones of the forearm
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Ilizarov technique in management of nonunited fracture of both bones of the forearm

机译：Ilizarov技术治疗前臂两块骨头的非统一骨折

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摘要

Nonunited fracture of the forearm, although not a common problem, is associated with marked disability. Nonunion can due to infection secondary to open fracture or can be a complication of surgical open reduction and internal fixation. Nonunion can also result from improper management or technique that is not suitable for the type of injury. This study reviews 11 patients with nonunited fractures of the shafts of the radius and ulna. Average duration of nonunion was 18 months. Nine patients presented with active infection or a history of infection in the form of open discharging wound with or without exposed bone, while two had no history of infection. Patients were managed by surgical debridment, removal of dead bone and hard wear, if any, and application of Ilizarov external fixation frame followed by acute shortening by compressing the fracture site. Three weeks later, gradual lengthening started to regain the normal length. Eradication of infection and sound union was achieved in all cases, with good hand, wrist, and elbow function on final follow-up. Limitation in pronation and supination ranges of movement were found in all cases. This could be due to multiple surgeries, long duration of management, the external fixation wires that crossed the distal and proximal radio-ulnar joints, or loss of the normal radial and ulnar bowing during lengthening. Ilizarov technique and external fixation represent an option in the management of resistant nonunion of diaphysial fractures in the forearm.
机译：前臂不统一的骨折虽然不是普遍的问题，但与残疾明显相关。骨不连可能是继发于开放性骨折的感染所致，也可能是外科手术减少切开术和内固定的并发症。不正确的管理或不适用于伤害类型的技术也可能导致骨不连。这项研究回顾了11例the骨和尺骨干不合并骨折的患者。平均不愈合时间为18个月。 9例患者出现活动性感染或有开放性伤口或无骨暴露形式的感染史，其中2例无感染史。通过外科手术清创术，去除死骨和硬磨损（如果有的话）并使用Ilizarov外固定架进行治疗，然后通过压缩骨折部位来进行急性缩短。三周后，逐渐变长开始恢复正常长度。在所有情况下，都可以根除感染和完全愈合，并在最终随访中具有良好的手，腕和肘部功能。在所有情况下均发现前旋和后旋运动范围受到限制。这可能是由于多次手术，长时间的治疗，穿过远端和近端proximal尺骨关节的外部固定线或在延长过程中失去正常的loss骨和尺骨弯曲所致。 Ilizarov技术和外固定术是治疗前臂骨干骨折抵抗性骨不连的一种选择。

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