外固定结合髓内钉固定的骨搬运技术治疗胫骨骨缺损临床疗效

doi:10.13418/j.issn.1001-165x.2023.2.18

中国临床解剖学杂志 ›› 2023, Vol. 41 ›› Issue (2): 224-229.doi: 10.13418/j.issn.1001-165x.2023.2.18

外固定结合髓内钉固定的骨搬运技术治疗胫骨骨缺损临床疗效

邵牧¹，罗俊浩¹，吴永伟¹，刘彬²，王超²，孙振中¹，芮永军¹，殷渠东¹*

1.无锡市第九人民医院骨科，江苏无锡 214062； 2.河北医科大学第三医院骨科，石家庄 050051

收稿日期:2021-10-17 出版日期:2023-03-25 发布日期:2023-04-17
通讯作者: 殷渠东，博士，主任医师，教授，E-mail：yinqudong @sina.com
作者简介:邵牧（1991-），江苏兴化人，硕士，住院医师，研究方向：创伤骨科，E-maill：smx110923@163.com

Clinical effect of bone transport of external fixation combined with intramedullary nail in the treatment of tibial bone defects

Shao Mu¹, Luo Junhao¹, Wu Yongwei¹, Liu Bin², Wang Chao², Sun Zhenzhong¹, Rui Yongjun¹, Yin Qudong²*

1. Department of Orthopaedics, Wuxi the Ninth People's Hospital, Wuxi 214062, Jiangsu Province, China; 2. Department of Orthopaedics, the Third Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei Province, China

Received:2021-10-17 Online:2023-03-25 Published:2023-04-17

摘要/Abstract

摘要： 目的探讨外固定结合髓内钉固定的骨搬运技术治疗胫骨骨缺损的临床效果。方法回顾分析2012年1月~2020年5月本院采用骨搬运技术治疗胫骨骨缺损58例，按方法不同分为传统外固定组（传统组，40例）和外固定结合髓内钉固定组（结合组，18例），两组患者性别、年龄、病程、骨缺损长度、类型、合并伤、手术次数、骨搬运术前邻近关节评分等一般情况比较，差异无统计学意义（P>0.05）。比较二组切口和骨愈合、外固定时间、愈合指数、下肢功能、并发症、身体和精神健康等情况，采用Ilizarov技术研究与应用学会（ASAMI）方法评价骨愈合和下肢功能恢复，按Paley标准将Ilizarov术后并发症分为主要和次要并发症，健康调查简表（SF-36）评价生理功能（PCS）和精神健康质量（MCS）。结果患者均获随访，随访时间16~40个月，平均25.5个月。结合组的外固定时间、骨愈合时间、术后主要并发症、次要并发症和MCS优于传统组，差异有统计学意义（P<0.05）；切口愈合、延长指数、下肢功能恢复和PCS，二组差异无统计学意义（P>0.05）。结论外固定结合髓内钉固定的骨搬运技术治疗胫骨骨缺损，可避免对位不良和畸形愈合，明显减少外固定时间，减少并发症和精神心理健康不利影响。

关键词: 胫骨； , , 骨缺损； , , 骨搬运； , , 髓内钉； , , 并发症

Abstract: Objective To investigate the clinical effect of tibial bone defects treated with bone transport of external fixation combined with intramedullary nail. Methods From January 2012 to May 2020, data of 58 patients with tibial bone defects treated with bone transport were retrospectively analyzed. According to different treatment methods, they were divided into an external fixation group (traditional group, 40 cases) and an external fixation with intramedullary nail fixation group (combined group, 18 cases). There was no statistical difference between the two groups in gender, age, course of disease, length and type of bone defect, combined injury, number of operations and score of adjacent joints before bone handling (P>0.05). The wound healing, bone healing, external fixation time, healing index, lower limb functional recovery, complications, physical and mental health were compared. Bone healing and functional recovery of lower extremity were evaluated according to ASAMI. The complications of Ilizarov technique were classified into major and minor complications according to Paley method. The physiological function (PCS) and mental health quality (MCS) were evaluated respectively by item short form health survey (SF-36). Results All patients were followed up for 16 to 40 months, with an average of 25.5 months. The external fixation time, bone healing time, postoperative major complications, minor complications and MCS in the combined group were significantly better than those in the traditional group (P<0.05). There was no significant difference in incision healing, healing index, lower limb functional recovery and PCS (P>0.05). Conclusions External fixation with intramedullary nail fixation for tibial bone defects can avoid poor alignment and malunion, significantly reduce the external fixation time, complications and adverse effects on mental health.

Key words: Tibia; , , Bone defect; , , Bone transport; , , Intramedullary nail; , , Complication

中图分类号:

R681.8

邵牧, 罗俊浩, 吴永伟, 刘彬, 王超, 孙振中, 芮永军, 殷渠东. 外固定结合髓内钉固定的骨搬运技术治疗胫骨骨缺损临床疗效[J]. 中国临床解剖学杂志, 2023, 41(2): 224-229.

Shao Mu, Luo Junhao, Wu Yongwei, Liu Bin, Wang Chao, Sun Zhenzhong, Rui Yongjun, Yin Qudong. Clinical effect of bone transport of external fixation combined with intramedullary nail in the treatment of tibial bone defects [J]. Chinese Journal of Clinical Anatomy, 2023, 41(2): 224-229.

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外固定结合髓内钉固定的骨搬运技术治疗胫骨骨缺损临床疗效

Clinical effect of bone transport of external fixation combined with intramedullary nail in the treatment of tibial bone defects

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