经皮微创定点取骨、植骨治疗股骨、胫骨内固定术后骨不连、骨延迟【摘要】目的：探?使用经皮微创定点取骨器微创取骨、经皮微创植骨的方法治疗16例内固定术后股骨、胫骨骨不连或骨延迟愈合患者的临床疗效。方法：选取2010年1月-2016年7月采用自制经皮微创定点取骨器微创取骨、经皮微创植骨方法治疗的股骨、胫骨内固定术后骨不连或骨延迟愈合患者16例。对患者术中及术后情况进行统计，观察患者取骨量、取骨及植骨手术时间、出血量、术后并发症、住院天数、骨的愈合情况。结果：本组16例患者均获随访，随访时间6～35个月，平均（14.8±1.7）个月。16例病例中单处单向取骨8例，单处双向取骨7例，多点取骨1例，平均取骨量（3.9±1.6）cm3，平均取骨时间（6.8±1.3）min，植骨时间平均（13.5±1.2）min，平均取骨出血量约（5.9±1.1）mL，植骨平均出血量约（10.9±1.4）mL，平均住院天数为5d。15例骨折延迟愈合或骨不连患者在术后5～11个月达到骨性愈合，平均（7.3±1.1）个月。1例植骨部位出现浅表皮肤感染，1例出现取骨部位伤口血肿，1例胫骨中下1/3骨不连患者植骨后12个月X线片中骨折线仍然明显，无骨痂连接。所有病例均未出现骨髓炎、骨化性肌炎，内固定松动、钉板断裂等并发症。结论：经皮微创定点取骨器微创取骨、微创植骨具有操作简便、创伤小、出血少、手术及住院时间短、并发症少、愈合快等优点，对治疗股骨、胫骨术后骨不连、骨延迟愈有良好的疗效。【关键词】微创取骨术；微创植骨术；骨移植；骨不连；骨延迟愈合CurativeEffectObservationofPercutaneousMinimallyInvasiveFixed-pointBoneextractionandGraftingaftertheTreatmentofFemoralorTibialInternalFixationinNonunionorDelayedUnion/MABang-xing，RENShao-dong，CHENZe-qun，etal.//MedicalInnovationofChina，2017，14（16）：046-050【Abstract】Objective：Toinvestigatethecurativeeffectofminimallyinvasivefixed-pointpercutaneousiliacbonegraftinthetreatmentof16patientswithfemoralortibialofnonunionordelayedunionofboneafterinternalfixation.Method：FromJanuary2010toJuly2016，16patientsoffemoralortibialinnonunionordelayedunionofbonewereselectedwithourself-madepercutaneousminimallyinvasiveinstrumentfixed-pointinternalfixationgraftthebone.Thethevolumeofbonegraft，operationtime，bleedingvolume，postoperativecomplications，hospitalstays，bonehealingconditionofallthepatientswereobserved.Result：Allthe16patientswerefollowedup6to35months，averageof（14.8±1.7）months.Among16cases，8caseswereonepointonedirection，7caseswereonepointtwodirections，1caseofmultiplepointbonegraft，theaveragebonevolumewas（3.9±1.6）cm3，theaveragetimeofIliacbonegrafwas（6.8±1.3）min，theaveragetimeofbonegraftingwas（13.5±1.2）min，theaveragebleedingvolumeofbonetakingwas（5.9±1.1）mL，theaveragebleedingvolumeofbonegraftingwasabout（10.9±1.4）mL，theaveragehospitalstayswere5days.15cases’bonehealingwithin5-11months，theoperationaveragewere（7.3±1.1）months.1case’sbonegraftsiteappearedsuperficialskininfection，1case’sdonorsiteappearedwoundhematoma，1case’s1/3lowertibialnonunionX-rayafterbonegrafting12monthsshowedthefracturelinestillevident，nobonecallusconnection.Osteomyelitis，ossificansmyositisinternalfixationloosening，platefractureandothercomplicationswerenotfoundinallcases.Conclusion：Minimallyinvasivefixed-pointandpercutaneousbonegraftisasimpleandeasywayforoperation，canreducetraumaandbleeding，shortenoprationtimeandhospitalstays，decreacethecomplicationsandacceleratehealing，whichhasagoodeffectforfemoralortibialnonunionordelayedunionofboneafterinternalfixation.【Keywords】Minimallyinvasiveboneextraction；Minimallyinvasivebonegrafting；Bonegrafting；Nonunion；Bonedel...