| Objective:To compare the clinical effects of segment bone transport with the inlaid external fixator and dynamical compressive plate internal fixation combined with bone transplant for nonunion of the femur associated with extremity length discrepancy, provide evidence for clinical reasonable select therapy.Method: A retrospective study was conducted in 60 patients who underwent segment bone transport with the inlaid external fixator or dynamic compressive plate internal fixation combined with bone transplant for nonunion of the femur associated with extremity length discrepancy since October 2000. Segment bone transport with the inlaid external fixator in 32 cases, male 23 cases,female 9 cases,aged from 6～52(average 31.4), and dynamic compressive plate internal fixation combined with bone transplant in 28 cases, including 18 cases of male and 10 cases of female who aged 10～46 with average of 38.2.Results: All of the patients were followed-up.1: Segment bone transport with the inlaid external fixator group: Followed-up for 9～39 months after operation , healing -rate was 100%,the time of healing averaged 6.6 months(4～13 months),and all the patients resumed the normal length of limbs. 6 cases angulated but less than 7°; 18 puncturing-sites infected in 15 cases; but no osteomyelitis and no injury of nerve and vessel. 2: Dynamic Compressive Plate internal fixation combined with bone transplant group :followed-up for 10～44 months , healing -rate was 82.1%, the time of healing averaged 8.3 months(6～18 months),but only 75 % has resumed the normal length of limbs . 1 cases show bone incoherence after one year by x-ray. The transplanted bone absorbed and infected in One case,one has the plate ruptured ,and one has the nail loosened; no nerve and vessel injury.Conclusion: Two methods are all the effective treatment for nonunion of the femur associated with extremity length discrepancy,but the fomer better than the later in nonunion of the femur associated with extremity lengthy discrepancy. |
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