本文已被:浏览 877次 下载 508次
Received:April 20, 2018 Published Online:September 20, 2018
Received:April 20, 2018 Published Online:September 20, 2018
中文摘要: 目的 对比Ilizarov环形外固定支架与Orthofix外固定架骨搬移术治疗胫骨骨缺损的临床疗效。方法 回顾性分析2014年4月至2016年9月收治的72例胫骨骨缺损患者的临床资料,采用Ilizarov环形外固定法的36例为A组,采用Orthofix外固定法的36例为B组。两组均随访至外固定架取出,评价对比两组患者术中术后相关指标:骨延长长度、愈合指数、再生骨比例、外固定指数(再生骨1 cm所需要时间)、愈合时间、延长期骨矿化时间,带架时间以及术后并发症发生率。参照Johner-Wruhs法对患者胫骨恢复情况进行评定。结果 A组患者手术时间低于B组,术中出血量多于B组,差异有统计学意义(P<0.01)。但两组住院时间、随访时间对比差异无统计学意义(P>0.05)。两组患者在愈合时间、骨延长长度、愈合指数、再生骨比例、外固定指数、延长期骨矿化时间、带架时间方面对比,差异无统计学意义(P>0.05)。A组恢复优良率高于B组(83.33% vs 58.33%,P<0.05)。两组患者并发症总发生率对比差异无统计学意义(72.22% vs 75.00%,P>0.05),其中A组骨折畸形愈合发生率低于B组(P<0.05),足下垂发生率高于B组(P<0.01)。结论 采用Ilizarov环形外固定治疗胫骨骨缺损患者术后恢复疗效优于采用Orthofix外固定治疗,术后骨偏移发生率较低,但发生足下垂率较高。
Abstract:Objective To compare the clinical effects of bone transport surgery with Ilizarov ring external fixator and Orthofix external fixator in the treatment of tibial bone defects. Methods Seventy-two patients with tibial bone defect from April 2014 to December 2016 were retrospectively studied and were divided into group A (Ilizarov ring external fixator, n=36) and group B (Orthofix external fixator, n=36). All patients were followed up to the extraction time of external fixator. Intra- and post-operative related parameters, length of bone lengthening, healing index, and external fixation index (the time needed for regenerating bone 1 cm), bone regeneration ratio bone healing time, bone mineralization duration, shelf-carring time and postoperative complication rate were evaluated and compared between two groups. The tibial recovery situation was assessed by the Johner-Wruhs criteria. Results Compared with group B, the operation time decreased, and intraoperative blood loss increased in group A (P<0.05). However, there were no significant differences in hospital stay, follow-up time, healing time, bone lengthening length, healing index, the ratio of bone regeneration, external fixation index, bone mineralization time and shelf-carring time between two groups (all P>0.05). The excellent recovery rate in group A was higher than that in group B (83.33% vs 58.33%, P<0.05). There was no significant difference in total incidence rate of complication between two groups (72.22% vs 75.00%, P>0.05), but the incidence of nail tract infection and fracture malunion was statistically lower(P<0.05), and the incidence of foot drooping was statistically higher in group A compared with group B(P<0.01). Conclusion The therapeutic effect of Ilizarov ring external fixation is better than that of Orthofix external fixation in the surgery treatment of tibial bone defect with lower incidence of post-operative bone transport and higher probability of foot drop.
keywords: Tibial bone defect Bone transport surgery External fixator Ilizarov ring external fixator Orthofix external fixator Johner-Wruhs criteria
文章编号: 中图分类号:R 682.6 文献标志码:A
基金项目:湖北省自然科学基金(2015CFB149)
Author Name | Affiliation |
SAN Jun-cheng, LUO Wen, LI Ji-qing | Department of Orthopedics, the 477 Hospital of PLA, Xiangyang, Hubei, 441021, China |
Author Name | Affiliation |
SAN Jun-cheng, LUO Wen, LI Ji-qing | Department of Orthopedics, the 477 Hospital of PLA, Xiangyang, Hubei, 441021, China |
引用文本: