摘要
目的探究骨搬运技术联合骨水泥分段填塞与骨短缩-延长术治疗创伤后胫骨大段骨缺损患者的临床疗效比较。方法回顾性分析2018年1月至2023年8月我院收治的63例[男40例,女23例,平均年龄(48.75±6.13)岁]创伤后胫骨大段骨缺损患者,按照手术方式不同分为对照组(采用骨搬运技术联合骨水泥分段填塞进行治疗,30例)、试验组(采用骨短缩-延长术进行治疗,33例),比较两组一般情况、骨愈合程度、下肢功能评分、并发症和骨折愈合时间。结果试验组术中术后出血量和总引流量明显高于对照组(P<0.05);试验组和对照组骨愈合优良率比较(90.91%,96.67%),差异无统计学意义(P>0.05);试验组和对照组术后1、3、6个月美国特种外科医院(HSS)膝关节评分、踝关节Baird-Jackson评分经重复测量方差分析显示,组间差异有统计学意义(F=5.085,P=0.025;F=6.129,P=0.014),除术前以外,不同时间点差异均有统计学意义(F=203.151,P<0.001;F=189.122,P<0.001),组间和时间无交互作用(F=1.339,P=0.262;F=2.262,P=0.082);试验组和对照组主要、次要并发症发生情况(主要:12.12%,23.33%;次要:30.30%,46.67%)比较均差异无统计学意义(P>0.05);试验组骨缺损端自然愈合时间明显短于对照组(P<0.05)。结论骨搬运技术联合骨水泥分段填塞与骨短缩-延长术均能有效促进创伤后胫骨大段骨缺损患者的骨愈合,改善患者膝关节和踝关节功能,具有相似并发症发生率,但骨搬运技术联合骨水泥分段填塞术中术后出血量和引流量较少,骨短缩-延长术的骨折愈合时间相对更短。
Objective To compare efficacy of bone transport technology combined with segmented filling with bone cement and the bone shortening-lengthening surgery in treating patients with large tibial bone defects after trauma.Methods A total of 63 patients(there were 40 males and 23 females with an average age of(48.75±6.13)years)with post-traumatic large tibial bone defect admitted to our hospital from January 2018 to August 2023 were divided into control group(30 cases were treated by bone handling technology combined with bone cement segmental packing)and experimental group(33 cases were treated by bone shortening and lengthening)according to different surgical methods.The general condition,the degree of bone healing,lower limb function score,complications,and fracture healing time were compared between the two groups.Results The intraoperative and postoperative blood loss and total drainage volume in the experimental group were significantly higher than those in the control group(P<0.05);There was no statistically conspicuous difference in excellent rate of bone healing between experimental group and control group(90.91%,96.67%)(P>0.05).The knee score and ankle Baird-Jackson score obtained by the Hospital for Special Surgery(HSS)of the experimental group and the control group at 1,3 and 6 months after surgery by repeated measurement ANvariance analysis showed statistically significant differences between the experimental group and the control group(F=5.085,P=0.025;F=6.129,P=0.014),except before surgery,the difference was statistically significant at different time points(F=203.151,P<0.001;F=189.122,P<0.001),there was no interaction between groups and time(F=1.339,P=0.262;F=2.262,P=0.082)There was no statistically conspicuous difference in incidence of primary and secondary complications between experimental group and control group(primary:12.12%,23.33%;secondary:30.30%,46.67%)(P>0.05).The natural healing time of bone defects in experimental group was conspicuously shorter than that in control group(P<0.05).Conclusions Bone transport technology combined with segmented bone cement packing and bone shortening-lengthening surgery can both effectively promote bone healing in patients with large tibial bone defects after trauma,improve the functions of the knee and ankle joints of patients,and have similar complication rates.However,the intraoperative and postoperative blood loss and drainage volume of bone transport technology combined with segmented bone cement packing are less,and the fracture healing time of bone shortening-lengthening surgery is relatively shorter.
作者
皮秀敏
张云鹏
屈伟
胡宏宇
Pi Xiumin;Zhang Yunpeng;Qu Wei;Hu Hongyu(Department of Operating Room,Tangshan Second Hospital,Tangshan 063000,China;Department of Hands,Tangshan Second Hospital,Tangshan 063000,China)
出处
《中华老年骨科与康复电子杂志》
2025年第4期237-244,共8页
Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)
基金
河北省医学科学研究重点课题计划项目(20250123)。
关键词
胫骨大段骨缺损
骨搬运技术
骨水泥分段填塞
骨短缩-延长术
临床疗效
Large tibial bone defect
Bone transport technology
Segmented filling with bone cement
Bone shortening-lengthening surgery
Efficacy
作者简介
通信作者:皮秀敏,Email:yao57668@163.com。
