胫骨中下段骨折不愈合原因的研究进展
常文利
张英泽
陈伟
1.河北医科大学第三医院创伤急救中心, 石家庄,0500512.河北医科大学第三医院创伤急救中心, 石家庄,0500513.河北医科大学第三医院创伤急救中心, 石家庄,050051
摘要：The incidence of tibial shaft fracture accounts for 24.75％ in all adults with tibiofibular fracture. The delayed union rate of open tibial fracture was 6.80％, and that for the middle third tibial fracture 92.40％. Special anatomical features of the middle and distal tibial fracture and the injury mechanism are important factors, affecting the tibial fracture healing. The blood supply of the tibial shaft is composed of three vascular systems: nutrient artery system, periosteum vascular system, and metaphyseal vascular system. If any of these blood supplies was destroyed, the rate of tibial fracture delayed union and nonunion can reach more than 3 times. Soft tissue defect with arterial damage is a risky factor for delayed union. Besides, age, smoking, previous history of fracture, drug combination, fracture types, and operation approaches also can result in the middle and distal tibial fracture nonunion. Endocrine metabolic disease is also an important factor to hinder the bone formation, such as diabetes, thyroid disease, vitamin D deficiency, and lack of estrogen. Clinical doses of nonselective NSAIDs can reduce calcium levels and hydroxyproline levels, subsequently increase the rate of nonunion. Cox-2-selective inhibitors can inhibit mesenchymal cell differentiation into osteoblasts. All the above-mentioned factors eventually lead to tibial fracture nonunion. This article reviews causes of the tibial delayed union and nonunion and their related treatment measures with the aim to improve the outcomes of clinical treatment.
关键词：胫骨骨折骨折不愈合延迟愈合综述
分类号：R683.4(骨科学（运动系疾病、矫形外科学）)
论文发表日期：2017-01-01
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：4( 713-716 )
英文信息