Strategy and adjuvant therapy of internal fixation implant and external fixation stent for treating tibial fracture nonunion / 中国组织工程研究

ABSTRACT

BACKGROUND:Nonunion is a common clinical problem in the prognosis of tibial fracture. The treatment method of tibial fracture nonunion is extensive and develops rapidly. Different repair plans should be taken to the nonunion of tibial fractures caused by different factors. OBJECTIVE:To summarize the repair strategy and effect of adjuvant therapy of internal fixation implants and external fixation stent for treatment of tibial fracture nonunion. METHODS:The PubMed database and CNKI database were retrieved by the author of this article for the published articles related to reason and treatment method of nonunion. The key words were “tibial fracture nonunion, reason,treatment, implant, external fixation”. The repetitive and old articles were eliminated. RESULTS AND CONCLUSION:(1) Finaly 35 articles were selected for further analysis. (2) Surgical method is the chief treatment for tibial fracture nonunion. We choosedifferent surgical methods for the best curative effect according to the reasons of nonunion and whether it is infected or not. The biological and structural factors that cause bone delayed healing should be considered in the treatment. (3) The fixed treatment on the structure is divided into external fixation and internal fixation. Intramedulary nail and compression plate can give stability of nonunion without infected tibial fractures, and it is a good solution to the structural problems. External fixation can be used for nonunion of infected tibial fracture. (4) To solve the biological problems of nonunion of tibial fractures (bone defect), various bone grafting materials and bone grafting techniques can be used. It is generaly required to fix the bonegraft in the treatment of nonunion of the tibia fracture. In recent years, biological materials have been gradualy applied to solve the problem of bone nonunion of tibial fractures. Although electrical stimulation and ultrasound have been shown to promote fracture healing, it has not been clinicaly proven to be used in the treatment of nonunion of tibial fractures.