摘要
目的探讨骨搬移治疗胫骨慢性骨髓炎并发对合端不愈合的危险因素。方法回顾性分析138例行骨搬移治疗的创伤性胫骨慢性骨髓炎患者的临床资料。对可能影响对合端愈合的因素进行单因素分析,并进一步采用Logistic回归进行多因素分析,筛选危险因素。结果138例患者获得8~48个月随访,平均随访(24.76±8.49)个月。术后对合端愈合81例;对合端不愈合57例,发生率为41.3%,其中对合端骨质硬化21例(15.2%),线位不良18例(13.0%),折端骨质吸收萎缩13例(9.4%),软组织嵌顿5例(3.6%)。单因素分析结果显示,患者年龄、是否吸烟、局部软组织条件、骨块搬移距离、搬移方向是骨搬移治疗创伤性胫骨慢性骨髓炎术后并发对合端骨不愈合的影响因素(P<0.05)。多因素Logistic回归分析显示,患者年龄、是否吸烟、局部软组织条件、骨块搬移距离是骨搬移治疗创伤性胫骨慢性骨髓炎术后并发对合端不愈合的危险因素(P<0.05)。结论骨搬移技术是治疗创伤性胫骨慢性骨髓炎合并大段骨缺损的有效方法,术后并发对合端不愈合的概率高,年龄、是否吸烟、局部软组织条件、骨块搬移距离是其危险因素。
Objective To investigate the risk factors of non-union of the docking site after bone transfer for traumatic chronic osteomyelitis of the tibia.Methods The clinical data of 138 patients with traumatic tibia chronic osteomyelitis who underwent therapy by bone transfer were reviewed.Single factor analysis was used to analyze the related factors by Chi-square test,and logistic regression was used for multivariate analysis to screen risk factors.Results A total of 138 cases were followed up for 8-48 months,and the average was(24.76±8.49)months.Eighty-one cases had bone union and 57 cases had non-union,the incidence was 41.3%,including 21 cases(15.2%)due to osteoarthritis,18 cases(13.0%)with poor line position,13 cases(9.4%)with atrophy of bone resorption,and 5 cases(3.6%)with soft tissue incarceration.The results of single factor analysis showed that age,smoking,local soft tissue condition,bone moving distance and moving direction were the affecting factors fornon-union of the docking site after bone transfer for traumatic chronic osteomyelitis of the tibia(P<0.05).Multiple factor Logistic regression analysis showed that age,smoking,local soft tissue conditions,and bone moving distance were risk factors for non-union of the docking site after bone transfer for traumatic chronic osteomyelitis of the tibia(P<0.05).Conclusion Bone transfer is an effective method for the treatment of traumatic chronic osteomyelitis of the tibia combined with large bone defect,but there is a high probability of postoperative nonunion at the docking site.And age,smoking,local soft tissue conditions,and bone moving distance are risk factors.
作者
钟文龙
王新卫
杨思敏
郭再冉
张磊
陈江非
ZHONG Wen-long;WANG Xin-wei;YANG Si-min;GUO Zai-ran;ZHANG Lei;CHEN Jiang-fei(The First Department of Osteomyelitis, Luoyang Orthopedic Hospital of Henan Province, Henan Orthopedic Hospital, Luoyang 471002, China;Graduate School of Henan University of Chinese Medicine, Zhengzhou 450046, China)
出处
《河北医科大学学报》
CAS
2020年第5期545-548,553,共5页
Journal of Hebei Medical University
基金
河南省重点研发与推广专项(182102310487)
河南中医药大学研究生科研苗圃工程(MPYJS-2018-11)。
关键词
骨髓炎
胫骨
骨折
不愈合
osteomyelitis
tibia
fractures
ununited
作者简介
钟文龙(1990-),男,河南洛阳人,河南省洛阳正骨医院,河南省骨科医院医师,医学硕士,从事慢性骨髓炎并骨皮质缺损诊治研究;通信作者:王新卫,E-mail:lywxw188@163.com。
