Influencing factors of bone nonunion after intramedullary needle operation for tibial fracture

CHEN Shao-wei; LI Wen-bo; SHI Jie; YANG Wei-duo; ZHANG Yu-xiang; WANG Fu-hui; GAO Qiu-ming

doi:10.11659/jjssx.08E023105

您当前的位置：

首页 >

文章列表页 >

Influencing factors of bone nonunion after intramedullary needle operation for tibial fracture

Review | 更新时间：2024-10-22

- Influencing factors of bone nonunion after intramedullary needle operation for tibial fracture
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 33, Issue 10, Pages: 927-930(2024)
- 作者机构：
  
  1.中国人民解放军联勤保障部队第九四〇医院创伤骨科，甘肃兰州 730050
  2.宁夏医科大学临床医学院，宁夏银川 750004
  3.西北大学第一医院内分泌科，陕西西安 710000
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.08E023105
  CLC： R683.42
- Published：25 October 2024，
  
  Received：26 August 2023，
- 稿件说明：
移动端阅览
陈少伟,李文波,石杰等.胫骨骨折髓内针术后骨不愈合的影响因素[J].局解手术学杂志,2024,33(10):927-930.

CHEN Shao-wei,LI Wen-bo,SHI Jie,et al.Influencing factors of bone nonunion after intramedullary needle operation for tibial fracture[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(10):927-930.
陈少伟,李文波,石杰等.胫骨骨折髓内针术后骨不愈合的影响因素[J].局解手术学杂志,2024,33(10):927-930. DOI： 10.11659/jjssx.08E023105.

CHEN Shao-wei,LI Wen-bo,SHI Jie,et al.Influencing factors of bone nonunion after intramedullary needle operation for tibial fracture[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(10):927-930. DOI： 10.11659/jjssx.08E023105.

摘要

髓内针（IMN）治疗胫骨骨折具有愈合率高、并发症发生率低等优点，已成为治疗胫骨骨折最常用的固定方式之一。但受患者自身因素、骨折部位及骨折类型、感染和手术治疗方式等因素的影响，IMN术后骨不愈合在临床中仍有发生。骨不愈合导致患者的医疗费用增加，住院时间延长，给患者造成了巨大的痛苦，同时也给骨科医生的治疗带来了巨大挑战。因此，本文对胫骨骨折IMN术后骨不愈合的影响因素作一综述，以期为临床治疗提供参考。

Abstract

Intramedullary needle （IMN） has the advantages of high healing rate and low incidence of complications in treatment of tibial fracture， and has become one of the most commonly used fixation methods for the treatment of tibial fracture. However， due to the patient's own factors， fracture location and fracture type， infection and surgical treatment， bone nonunion after IMN still occurs in clinic. Bone nonunion leads to the increase of medical cost and prolonged the hospitalization time of patients， which causes great pain to patients， and also brings great challenges to the treatment of orthopedic surgeons. Therefore， this paper reviews the influencing factors of bone nonunion after IMN for tibial fracture， in order to provide reference for clinical treatment.

关键词

骨不愈合胫骨骨折髓内针骨折固定术影响因素综述

Keywords

bone nonuniontibial fractureintramedullary nail fracture fixationinfluencing factorsreview

references

Lai TC，Fleming JJ.Minimally invasive plate osteosynthesis for distal tibia fractures［J］.Clin Podiatr Med Surg，2018，35（2）：223-232.doi：10.1016/j.cpm.2017.12.005http://dx.doi.org/10.1016/j.cpm.2017.12.005.

Manon J，Detrembleur C，Van de Veyver S，et al.Predictors of mechanical complications after intramedullary nailing of tibial fractures［J］.Orthop Traumatol Surg Res，2019，105（3）：523-527.doi：10.1016/j.otsr.2019.01.015http://dx.doi.org/10.1016/j.otsr.2019.01.015.

Kawasaki N，Takegami Y，Sakai R，et al.Prediction of delayed union of tibial shaft fracture treated with intramedullary nailing：multicenter-study analysis and literature review-the TRON study［J］.Eur J Orthop Surg Traumatol，2022，32（1）：129-135.doi：10.1007/s00590-021-02939-9http://dx.doi.org/10.1007/s00590-021-02939-9.

Panteli M，Vun JSH，Pountos I，et al.Biological and molecular profile of fracture non-union tissue：a systematic review and an update on current insights［J］.J Cell Mol Med，2022，26（3）：601-623.doi：10.1111/jcmm.17096http://dx.doi.org/10.1111/jcmm.17096.

Tian R，Zheng F，Zhao W，et al.Prevalence and influencing factors of nonunion in patients with tibial fracture：systematic review and meta-analysis［J］.J Orthop Surg Res，2020，15（1）：377.doi：10.1186/s13018-020-01904-2http://dx.doi.org/10.1186/s13018-020-01904-2.

Kim CH，Kim DH，Kang HV，et al.Factors affecting healing following percutaneous intramedullary fixation of metacarpal fractures［J］.Medicine （Baltimore），2021，100（50）：e27968.doi：10.1097/MD. 0000000000027968http://dx.doi.org/10.1097/MD.0000000000027968.

Wildemann B，Ignatius A，Leung F，et al.Non-union bone fractures［J］.Nat Rev Dis Primers，2021，7（1）：57.doi：10.1038/s41572-021-00289-8http://dx.doi.org/10.1038/s41572-021-00289-8.

Yang J，Zhang X，Liang W，et al.Efficacy of adjuvant treatment for fracture nonunion/delayed union：a network meta-analysis of randomized controlled trials［J］.BMC Musculoskelet Disord，2022，23（1）：481.doi：10.1186/s12891-022-05407-5http://dx.doi.org/10.1186/s12891-022-05407-5.

Schmittenbecher P.Nonunion of fractures in children［J］.Eur J Trauma Emerg Surg，2021，47（2）：281-282.doi：10.1007/s00068-021-01609-zhttp://dx.doi.org/10.1007/s00068-021-01609-z.

Shapiro JA，Stillwagon MR，3rdTornetta P，et al.Serology and comorbidities in patients with fracture nonunion：a multicenter evaluation of 640 patients［J］.J Am Acad Orthop Surg，2022，30（18）：e1179-e1187.doi：10.5435/JAAOS-D-21-00366http://dx.doi.org/10.5435/JAAOS-D-21-00366.

Bauwens PH，Malatray M，Fournier G，et al.Risk factors for complications after primary intramedullary nailing to treat tibial shaft fractures：a cohort study of 184 consecutive patients［J］.Orthop Traumatol Surg Res，2021，107（3）：102877.doi：10.1016/j.otsr. 2021.102877http://dx.doi.org/10.1016/j.otsr.2021.102877.

Jeffcoach DR，Sams VG，Lawson CM，et al.Nonsteroidal anti-inflammatory drugs' impact on nonunion and infection rates in long-bone fractures［J］.J Trauma Acute Care Surg，2014，76（3）：779-783. doi：10.1097/TA.0b013e3182aafe0dhttp://dx.doi.org/10.1097/TA.0b013e3182aafe0d.

Tucker WA，Birt MC，Heddings AA，et al.The effect of postoperative nonsteroidal anti-inflammatory drugs on nonunion rates in long bone fractures［J］.Orthopedics，2020，43（4）：221-227.doi：10.3928/01477447-20200428-06http://dx.doi.org/10.3928/01477447-20200428-06.

Fowler T，Whitehouse M，Riddick A，et al.A retrospective comparative cohort study comparing temporary internal fixation to external fixation at the first stage debridement in the treatment of type IIIB open diaphyseal tibial fractures［J］.J Orthop Trauma，2019，33（3）：125-130.doi：10.1097/BOT.0000000000001362http://dx.doi.org/10.1097/BOT.0000000000001362.

Tucker NJ，Mauffrey C，Parry JA.Are pre- and postoperative true translational and angular displacement predictive of nonunion after intramedullary nail fixation of tibial shaft fractures？［J］.Eur J Orthop Surg Traumatol，2023，33（1）：37-43.doi：10.1007/s00590-021-03154-2http://dx.doi.org/10.1007/s00590-021-03154-2.

Yang L，Sun Y，Li G.Comparison of suprapatellar and infrapatellar intramedullary nailing for tibial shaft fractures：a systematic review and meta-analysis［J］.J Orthop Surg Res，2018，13（1）：146.doi：10.1186/s13018-018-0846-6http://dx.doi.org/10.1186/s13018-018-0846-6.

Packer TW，Naqvi AZ，Edwards TC.Intramedullary tibial nailing using infrapatellar and suprapatellar approaches：a systematic review and meta-analysis［J］.Injury，2021，52（3）：307-315.doi：10.1016/j.injury.2020.09.047http://dx.doi.org/10.1016/j.injury.2020.09.047.

Whiting PS，Galat DD，Zirkle LG，et al.Risk factors for infection after intramedullary nailing of open tibial shaft fractures in low- and middle-income countries［J］.J Orthop Trauma，2019，33（6）：e234-e239.doi：10.1097/BOT.0000000000001441http://dx.doi.org/10.1097/BOT.0000000000001441.

Martus JE.Operative fixation versus cast immobilization：tibial shaft fractures in adolescents［J］.J Pediatr Orthop，2021，41（Suppl 1）：S33-S38.doi：10.1097/BPO.0000000000001806http://dx.doi.org/10.1097/BPO.0000000000001806.

O'Malley O，Trompeter AJ，Krishnanandan S，et al.How common are vascular injuries in open tibial fractures？A prospective longitudinal cohort study［J］.Eur J Orthop Surg Traumatol，2019，29（5）：1119-1124.doi：10.1007/s00590-019-02416-4http://dx.doi.org/10.1007/s00590-019-02416-4.

Pennock AT，Huang SG，Pedowitz JM，et al.Risk factors for adverse radiographic outcomes after elastic stable intramedullary nailing of unstable diaphyseal tibia fractures in children［J］.J Pediatr Orthop，2020，40（9）：481-486.doi：10.1097/BPO.0000000000001565http://dx.doi.org/10.1097/BPO.0000000000001565.

Metcalf KB，Smith EJ，Wetzel RJ，et al.Comparison of clinical outcomes after intramedullary fixation of tibia fractures caused by blunt trauma and civilian gunshot wounds：a retrospective review［J］.J Orthop Trauma，2020，34（6）：e208-e213.doi：10.1097/BOT. 0000000000001709http://dx.doi.org/10.1097/BOT.0000000000001709.

Umur L，Sari E，Orhan S，et al.Dilemma of supra- or infrapatellar tibial nailing：anterior knee pain vs.intra-articular damage［J］.Int J Clin Pract，2022：8220030.doi：10.1155/2022/8220030http://dx.doi.org/10.1155/2022/8220030.

Cain ME，Hendrickx LAM，Bleeker NJ，et al.Prevalence of rotational malalignment after intramedullary nailing of tibial shaft fractures：can we reliably use the contralateral uninjured side as the reference standard？［J］.J Bone Joint Surg Am，2020，102（7）：582-591.doi：10.2106/JBJS.19.00731http://dx.doi.org/10.2106/JBJS.19.00731.

周潇逸，李付琦，唐昊，等.骨不连的生物学研究现状及治疗进展［J］.中国矫形外科杂志，2015，23（22）：2075-2078.doi：10.3977/j.issn.1005-8478.2015.22.14http://dx.doi.org/10.3977/j.issn.1005-8478.2015.22.14.

王小璐，崔宇，张令强.促进骨折愈合的治疗策略及机制研究进展［J］.生命科学，2021，33（1）：121-130.doi：10.13376/j.cbls/2021014http://dx.doi.org/10.13376/j.cbls/2021014.

Galvain T，Chitnis A，Paparouni K，et al.The economic burden of infections following intramedullary nailing for a tibial shaft fracture in England［J］.BMJ Open，2020，10（8）：e035404.doi：10.1136/ bmjopen-2019-035404http://dx.doi.org/10.1136/bmjopen-2019-035404.

Finelli CA，da Silva CB，Murça MA，et al.Microbiological diagnosis of intramedullary nailing infection：comparison of bacterial growth between tissue sampling and sonication fluid cultures［J］.Int Orthop，2021，45（3）：565-573. doi：10.1007/s00264-020-04771-yhttp://dx.doi.org/10.1007/s00264-020-04771-y.

Rupp M，Biehl C，Budak M，et al.Diaphyseal long bone nonunions- types，aetiology，economics，and treatment recommendations［J］.Int Orthop，2018，42（2）：247-258.

Chitnis AS，Vanderkarr M，Sparks C，et al.Complications and its impact in patients with closed and open tibial shaft fractures requiring open reduction and internal fixation［J］.J Comp Eff Res，2019，8（16）：1405-1416.doi：10.2217/cer-2019-0108http://dx.doi.org/10.2217/cer-2019-0108.

Hellwinkel JE，Working ZM，Certain L，et al.The intersection of fracture healing and infection：orthopaedics research society workshop 2021［J］.J Orthop Res，2022，40（3）：541-552.doi：10.1002/jor.25261http://dx.doi.org/10.1002/jor.25261.

Küntscher G.The intramedullary nailing of fractures［J］.J Orthop Trauma，2014，28（Suppl 8）：S3-S10.doi：10.1097/bot.00000000 00000184http://dx.doi.org/10.1097/bot.0000000000000184.

Tekin SB，Mert A，Bozgeyik B.Which is superior in the treatment of AO Type 42A tibial shaft fracture？ A comparison of talon intramedullary nailing and conventional locked intramedullary nailing［J］.Ulus Travma Acil Cerrahi Derg，2022，28（10）：1514-1520.doi：10.14744/tjtes.2021.36779http://dx.doi.org/10.14744/tjtes.2021.36779.

Bäcker HC，Heyland M，Wu CH，et al.Breakage of intramedullary femoral nailing or femoral plating：how to prevent implant failure［J］.Eur J Med Res，2022，27（1）：7.doi：10.1186/s40001-021-00630-7http://dx.doi.org/10.1186/s40001-021-00630-7.

Cong Y，Deng H，Lei J，et al.Comparison of the effects of intramedullary nailing and plate fixation on lower-extremity deep vein thrombosis after tibial fractures［J］.Comput Math Methods Med，2022，2022：4852201.doi：10.1155/2022/4852201http://dx.doi.org/10.1155/2022/4852201.

MacDonald DRW，Caba-Doussoux P，Carnegie CA，et al.Tibial nailing using a suprapatellar rather than an infrapatellar approach significantly reduces anterior knee pain postoperatively：a multicentre clinical trial［J］.Bone Joint J，2019，101-b（9）：1138-1143.doi：10.1302/0301-620X.101B9.BJJ-2018-1115.R2http://dx.doi.org/10.1302/0301-620X.101B9.BJJ-2018-1115.R2.

Sanghavi S，Patwardhan S，Shyam A，et al.Nonunion in pediatric femoral neck fractures［J］.J Bone Joint Surg Am，2020，102（11）：1000-1010.doi：10.2106/JBJS.19.01117http://dx.doi.org/10.2106/JBJS.19.01117.

韩超，马剑雄，马信龙.股骨干骨折不愈合影响因素及其干预方法［J］.中国矫形外科杂志，2018，26（8）：728-733.doi：10.3977/j.issn.1005-8478.2018.08.13http://dx.doi.org/10.3977/j.issn.1005-8478.2018.08.13.

王毅，王建平，李景峰，等.胫骨骨折不愈合及畸形愈合的治疗现状及进展［J］.中国骨与关节杂志，2018，7（3）：200-204.doi：10.3969/j.issn.2095-252X.2018.03.009http://dx.doi.org/10.3969/j.issn.2095-252X.2018.03.009.

Vaughn J，Gotha H，Cohen E，et al.Nail dynamization for delayed union and nonunion in femur and tibia fractures［J］.Orthopedics，2016，39（6）：e1117-e1123. doi：10.3928/01477447-20160819-01http://dx.doi.org/10.3928/01477447-20160819-01.

Azzam W，Gamal O，Samy A.Treatment of tibial shaft nonunion with a retained nail in morbidly obese patients［J］.Int Orthop，2022，46（5）：1123-1131.doi：10.1007/s00264-022-05326-zhttp://dx.doi.org/10.1007/s00264-022-05326-z.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Mechanism of overexpression of lncRNA HAGLR promoting osteogenic differentiation of bone marrow mesenchymal stem cells in rats with tibial fracture

Research progress on the mechanism of circular RNA involved in platinum resistance in ovarian cancer

Clinical progress of 3D printing technology in treatment of distal tibial epiphyseal fractures in adolescents

Research progress of inflammation-related signaling pathways in Parkinson's disease

Influencing factors of efficacy after total laminectomy in patients with multi-segment cervical ossification of posterior longitudinal ligment

Related Author

CUI Hong-wang

DENG Yang-liu

HUANG Zi-yi

CHEN Xin-yu

WANG Wen

LIU Bin-xin

FAN Ya-dan

LYU Chun-yan

Related Institution

Department of Emergency and Trauma Surgery， the First Affiliated Hospital of Hainan Medical College

Department of Gynecology， the Second Affiliated Hospital of Hainan Medical College

Department of Orthopedics， Wuxi Children's Hospital

Department of Pediatric Surgery， Wuxi People's Hospital Affiliated to Nanjing Medical University

Department of Human Anatomy/Development and Regeneration Key Laboratory of Sichuan Province， Chengdu Medical College

⁰