| Objectives The paper retrospectively analyzes clinical curative effect of Osteotomy lengthening technique on bone nonunion, and analyzes the experience of treatment process to explore the the clinical value of treatment method of lower limb long bone atrophy type of bone nonunion.Methods The paper takes some patients with disease of long tubular bone atrophy type bone nonunion in lower limb in traumatic orthopedics which were received from January, 2008 to September, 2014 by the Hospital of Ningxia Medical University. Participants included cases(19 cases), with an average age of 33.26 ±7.16(21 ~ 60 years old, 13 cases of male, female 6 cases, 5 cases of femoral lower-middle section of bone nonunion, 14 cases of tibial middle period of bone nonunion. And among them, 15 cases are bone nonunion of postoperative for steel plate internal fixation, 4 cases are intramedullary needle fixed postoperative bone nonunion. Cause for the first injury: 3 cases are for high falling injury, 7 cases are for traffic accident injury, and 9 cases are for heavy parts. The paper retrospectively makes use of the materials about Ilizarov bone cutting to extend the technology treatment of long tubular bone atrophy type bone nonunion in lower limber, and gets some information through medical records and telephone follow-up and outpatient follow-up of patients with collection, so that statistic data were retrospectively analyzed in the end. Main observation indexes: the healing time, preoperative evaluation of callus; Fracture healing condition evaluation of clinical curative effect; preoperative and postoperative knee HHS Baird- Jackson score, the score and ankle limb functional recovery of the evaluation. Corresponding data has been comprehensive anglicized by application SPSS17.0 statistical software package.Results In the study, 19 patients were received follow-up for an aerage of 12.26± 3.99 months(6 ~ 22). Bone nonunion are all got bony healing, and the average healing time was 8.89±3.05(4 ~ 18) months; Bone external fixator wearing time was averagely 10.79±2.63 months(6 ~ 15). According to Femadez- esteve callus radiological evaluation criteria, the results of postoperative bone heeling was presented in Table 1. The callus of nonunion in scoring was 2.94±0.71 points, while after treatment according to Paley[7]fracture ranging criteria the result are: 13 cases, 5 cases, 2 cases.There was no significant difference compared with the healthy limb in limb length. Limb after bone cutting to extend the knee, ankle joint function have a better recovery. According to the before and after the treatment of knee and ankle HHS Baird- Jackson function evaluation standard, knee, ankle joint function score before and after treatment had significant difference(P < 0.01). 6 cases of postoperative limb needle gets infected, and through treatment, needle cleaning and between the needle and the bandage iodine volts sand bars, between the skin and the external fixator tamponade dressing methods, the patients are under control. Bone extension shaft two offset, rehabilitation after bone cutting again, making increased bone healing time. 1 cases suffers from common nerve paralysis, 2 weeks after the suspension of bone traction and limb function exercise, the patients finally get recovered.Conclusion1. Osteotomy extended technology in longtubular bone atrophy of bone nonunion treatment curative effect is distinct.The technology has high cure rate, and it is an effective method of treatment.2. Osteotomy extended technology Atrophic nonunion of fracture end sclerotic bone,can reduce the iatrogenic injury of ilium, at the same time can achieve the purpose of healing of bone, and it is an effective method of treatment of atrophic nonunion of bone.3. This study doensn’t have sufficent cases, so it needs to continue to follow up to improve the information for further research. |
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